Consult Toolbox User Guide - VA



Consult ToolboxSoftware Version 1.9.0076User GuideSeptember 2020Department of Veterans AffairsOffice of Information and Technology (OIT)Revision HistoryNOTE: The revision history cycle begins once changes or enhancements are requested after the document has been baselined.DateRevisionDescriptionAuthor09/22/202015.0Release of version 1.9.0076. Updates include:Updated screen captures to reflect version number 1.9.0076.Added Unable to Schedule functionality to Receive Consult and Adding Comment to Consult section.Updated Receive Consult Menu Options screen.Updated Add Comment Menu Options screen.Added Community Cares Functions to Receiving Consult Activities section.AbleVets07/10/202014.0Release of version 1.9.0072. Updates include:Updated screen captures to reflect version number 1.9.0072.Added the Consult Previously Sent to HSRM message.Added Re-send to HSRM Referral check box.Updated the COVID-19 Consult Factor Types and Definitions table in Appendix B.Updated COVID-19 priority definitions.Updated screens to reflect COVID-19 priority definition updates.AbleVets05/01/202013.0Release of version 1.9.0065. Updates include:Coronavirus Disease of 2019 (COVID-19) updates.Updated screens to reflect new software version number.Added Appendix A1.3: Receive Community Care Functions: COVID-19 Priority.Added Appendix A2.3: Add Comment Community Care Functions: COVID-19 Priority.Updated COVID-19 Priority 1 and Priority 2 descriptions.Updated the Consult Factor Types and Definitions table in Appendix B.AbleVets04/17/202012.0Release of version 1.9.0063. Updates include:Coronavirus Disease of 2019 (COVID-19) updates.Added Enable COVID-19 workflow for Receive Consult and Clinical Review options check box under the Other User Settings tab.Added Appendix A: Management of Consults when COVID-19 Workflow is Enabled.Updated screen captures to reflect version number 1.9.0063.Updated the Consult Factor Types and Definitions table in Appendix B.AbleVets12/04/201911.0Release of version 1.9.0054. Updates include:Updated screen captures to reflect version number 1.9.0054.Updated Specific Eligibility Verified menu options under MSA Elig. Verification tab.Updated Forward to Community Care options.HSRM Forwarding ConsultsAbleVets6/04/201910.1Update of version 1.9.0004. CAN Score API updates include:Updated CAN Score description.Updated name from National Service Desk to Enterprise Service Desk.AbleVets5/07/201910.0Release of version 1.9.0004. Updates include:Updated screen captures to reflect version number 1.9.0004.Added CAN Score note. Updated SEOC from optional to mandatory.Removed Care Coordination from Community Care FunctionsUpdated SAR tab to Secondary Authorization Request (SAR)/Request for Service (RFS).Added Launch DST section.Added additional SEOC warning message.AbleVets11/06/20189.2Updated the Other User Settings screen capture. Added the Preferred Client Cert: content to the document.Software released to field as 1.9.002B.AbleVets8/28/20189.1Added Appendix A: Consult Factor Types and Definitions. AbleVets06/15/189.0Community Care SEOC functionality modified to utilize the SEOC DB, CAN Score functionality modified to utilize the CAN Score API when available, other functionality refined.v1.9.02AbleVets6/4/20188.0Community Care SEOC interim functionality expanded to include additional SEOCs, other functionality refined.V1.8.01AbleVets01/19/187.0Community Care SEOC interim functionality added, other functionality refinedv1.7.01AbleVets06/15/176.0Community Care Functions section, Enable/Disable functionality refinedv1.0.6051REDACTED05/04/175.1Enable and Disable functionality addedv1.0.0505REDACTED10/05/165.0Rework of community careRefinements of other modulesv1.0.5REDACTED04/05/164.0Deployment Versionv1.0.4REDACTED01/21/153.0Revisions to Discontinue consultv1.0.3REDACTED01/05/152.0Conversion to dialog boxesv1.0.2REDACTED11/27/151.0Initial Versionv1.0REDACTEDArtifact RationalePer the Veteran-focused Integrated Process (VIP) Guide, the User’s Guide is required to be completed prior to Critical Decision Point #2 (CD2), with the expectation that it will be updated as needed. A User Guide is a technical communication document intended to give assistance to people using a particular system, such as VistA end users. It is usually written by a technical writer, although it can also be written by programmers, product or project managers, or other technical staff. Most user guides contain both a written guide and the associated images. In the case of computer applications, it is usual to include screenshots of the human-machine interfaces, and hardware manuals often include clear, simplified diagrams. The language used is matched to the intended audience, with jargon kept to a minimum or explained thoroughly. The User Guide is a mandatory, build-level document, and should be updated to reflect the contents of the most recently deployed build. The sections documented herein are required if applicable to your product.Table of Contents TOC \o "1-1" \h \z \u \t "Heading 2,2,Heading 3,3,Heading 4,4,Heading 5,5,Heading 6,6" 1.Introduction PAGEREF _Toc51593911 \h 11.1.Purpose PAGEREF _Toc51593912 \h 11.2.Document Orientation PAGEREF _Toc51593913 \h 11.2.anization of the Manual PAGEREF _Toc51593914 \h 11.2.2.Assumptions PAGEREF _Toc51593915 \h 21.2.3.Coordination PAGEREF _Toc51593916 \h 21.2.4.Disclaimers PAGEREF _Toc51593917 \h 21.2.4.1.Software Disclaimer PAGEREF _Toc51593918 \h 21.2.4.2.Documentation Disclaimer PAGEREF _Toc51593919 \h 21.2.5.Documentation Conventions PAGEREF _Toc51593920 \h 31.2.6.References and Resources PAGEREF _Toc51593921 \h 31.3.Enterprise Service Desk and Organizational Contacts PAGEREF _Toc51593922 \h 32.System Summary PAGEREF _Toc51593923 \h 32.1.System Configuration PAGEREF _Toc51593924 \h 32.2.Data Flows PAGEREF _Toc51593925 \h 42.3.User Access Levels PAGEREF _Toc51593926 \h 42.4.Continuity of Operation PAGEREF _Toc51593927 \h 43.Getting Started PAGEREF _Toc51593928 \h 43.1.Accessing Consult Toolbox PAGEREF _Toc51593929 \h 43.1.1.Enabling Consult Toolbox PAGEREF _Toc51593930 \h 43.1.2.Setting Consult Toolbox Preferences PAGEREF _Toc51593931 \h 63.2.System Menu PAGEREF _Toc51593932 \h 123.2.1.Receive PAGEREF _Toc51593933 \h 123.2.2.Discontinue PAGEREF _Toc51593934 \h 133.2.3.Forward PAGEREF _Toc51593935 \h 133.2.4.Add Comment PAGEREF _Toc51593936 \h 133.2.5.Significant Findings PAGEREF _Toc51593937 \h 143.2.6.Administrative Complete PAGEREF _Toc51593938 \h 144.Using the Software PAGEREF _Toc51593939 \h 144.1.Receiving Consult Activities PAGEREF _Toc51593940 \h 154.1.1.Receiving Functions PAGEREF _Toc51593941 \h 154.1.1.1.Receiving Consult Steps PAGEREF _Toc51593942 \h 184.1.2.Unable to Schedule Functions PAGEREF _Toc51593943 \h 204.1.2.1.Unable to Schedule Steps PAGEREF _Toc51593944 \h 214.1.munity Care Functions PAGEREF _Toc51593945 \h 234.1.3.1.MSA Eligibility Verification PAGEREF _Toc51593946 \h 234.1.3.munity Care MSA Eligibility Verification Steps PAGEREF _Toc51593947 \h 254.1.3.2.munity Care (CC) Document Administrative Screening PAGEREF _Toc51593948 \h 264.1.3.2.1.munity Care (CC) Document Administrative Screening Steps PAGEREF _Toc51593949 \h 294.1.3.3.Consult Review PAGEREF _Toc51593950 \h 324.1.3.3.1.Consult Review Steps PAGEREF _Toc51593951 \h 344.1.3.3.2.Clinical Triage PAGEREF _Toc51593952 \h 364.1.3.3.2.1.Clinical Triage Steps PAGEREF _Toc51593953 \h 384.1.3.4.Authorization PAGEREF _Toc51593954 \h 414.1.3.4.1.Authorization Steps PAGEREF _Toc51593955 \h 444.1.3.5.DoD PAGEREF _Toc51593956 \h 464.1.3.5.1.DoD Steps PAGEREF _Toc51593957 \h 474.1.3.6.MSA Pt Contacts PAGEREF _Toc51593958 \h 494.1.3.6.1.MSA Pt Contacts Steps PAGEREF _Toc51593959 \h 534.1.3.7.Appt Tracking PAGEREF _Toc51593960 \h 554.1.3.7.1.Appt Tracking Steps PAGEREF _Toc51593961 \h 594.1.3.8.Secondary Authorization Request (SAR)/Request for Service (RFS) PAGEREF _Toc51593962 \h 614.1.3.8.1.SAR/RFS Steps PAGEREF _Toc51593963 \h 624.1.3.9.Consult Completion PAGEREF _Toc51593964 \h 644.1.3.9.1.Consult Completion Steps PAGEREF _Toc51593965 \h 664.2.Discontinuing Consult PAGEREF _Toc51593966 \h 674.2.1.Discontinuing In-house Consult Steps PAGEREF _Toc51593967 \h 704.2.2.Discontinuing Community Care Consult Steps PAGEREF _Toc51593968 \h 724.3.Forwarding Consult PAGEREF _Toc51593969 \h 744.3.1.Forwarding Consult Steps PAGEREF _Toc51593970 \h 754.4.Adding Comment to Consult PAGEREF _Toc51593971 \h 764.4.1.Scheduler Functions PAGEREF _Toc51593972 \h 764.4.1.1.Scheduling Calls and Letters PAGEREF _Toc51593973 \h 774.4.1.1.1.Scheduling Calls and Letters Steps PAGEREF _Toc51593974 \h 794.4.1.2.Scheduling and Rescheduling Efforts PAGEREF _Toc51593975 \h 814.4.1.2.1.Scheduling and Rescheduling Efforts Steps PAGEREF _Toc51593976 \h 834.4.1.munity Care Eligibility PAGEREF _Toc51593977 \h 864.4.1.3.munity Care Eligibility Steps PAGEREF _Toc51593978 \h 894.4.2.Unable to Schedule Functions PAGEREF _Toc51593979 \h 914.4.2.1.Unable to Schedule Steps PAGEREF _Toc51593980 \h 924.4.munity Care Functions PAGEREF _Toc51593981 \h 944.4.3.1.MSA Eligibility Verification PAGEREF _Toc51593982 \h 954.4.3.munity Care MSA Eligibility Verification Steps PAGEREF _Toc51593983 \h 964.4.3.2.munity Care (CC) Document Administrative Screening PAGEREF _Toc51593984 \h 984.4.3.2.1.munity Care (CC) Document Administrative Screening Steps PAGEREF _Toc51593985 \h 1014.4.3.3.Consult Review PAGEREF _Toc51593986 \h 1044.4.3.3.1.Consult Review Steps PAGEREF _Toc51593987 \h 1064.4.3.3.2.Clinical Triage PAGEREF _Toc51593988 \h 1084.4.3.3.2.1.Clinical Triage Steps PAGEREF _Toc51593989 \h 1104.4.3.4.Authorization PAGEREF _Toc51593990 \h 1144.4.3.4.1.Authorization Steps PAGEREF _Toc51593991 \h 1164.4.3.5.DoD PAGEREF _Toc51593992 \h 1194.4.3.5.1.DoD Steps PAGEREF _Toc51593993 \h 1204.4.3.6.MSA Pt Contacts PAGEREF _Toc51593994 \h 1224.4.3.6.1.MSA Pt Contacts Steps PAGEREF _Toc51593995 \h 1264.4.3.7.Appt Tracking PAGEREF _Toc51593996 \h 1284.4.3.7.1.Appt Tracking Steps PAGEREF _Toc51593997 \h 1324.4.3.8.Secondary Authorization Request (SAR)/Request for Service (RFS) PAGEREF _Toc51593998 \h 1344.4.3.8.1.SAR/RFS Steps PAGEREF _Toc51593999 \h 1354.4.3.9.Consult Completion PAGEREF _Toc51594000 \h 1374.4.3.9.1.Consult Completion Steps PAGEREF _Toc51594001 \h 1394.4.4.Clinical Review Options PAGEREF _Toc51594002 \h 1414.4.4.1.Setting Clinical Review Options PAGEREF _Toc51594003 \h 1434.4.5.Launch DST PAGEREF _Toc51594004 \h 1454.5.Significant Findings – Community Care Action Needed Notation PAGEREF _Toc51594005 \h 1464.5.1.Significant Findings Steps PAGEREF _Toc51594006 \h 1484.6.Administratively Complete PAGEREF _Toc51594007 \h 1504.6.1.Administratively Close Consult Steps PAGEREF _Toc51594008 \h 1505.Troubleshooting PAGEREF _Toc51594009 \h 1525.1.National Service Desk and Organizational Contacts PAGEREF _Toc51594010 \h 1526.Acronyms and Abbreviations PAGEREF _Toc51594011 \h 153Appendix A: Management of Consults when COVID-19 Workflow is Enabled PAGEREF _Toc51594012 \h 154Appendix A1: Receiving Consult Activities when COVID-19 Workflow is Enabled PAGEREF _Toc51594013 \h 154Appendix A1.1: VA Clinic Referrals PAGEREF _Toc51594014 \h 155Appendix A1.3: Receive Community Care Functions: COVID-19 Priority PAGEREF _Toc51594015 \h 160Appendix A2: Setting Clinical Review Options when COVID-19 Workflow is Enabled PAGEREF _Toc51594016 \h 164Appendix A2.1: VA Clinical Referrals PAGEREF _Toc51594017 \h 164Appendix A2.2: Community Care Referrals PAGEREF _Toc51594018 \h 169Appendix A2.3: Add Comment Community Care Functions: COVID-19 Priority PAGEREF _Toc51594019 \h 172Appendix B: Consult Factor Types and Definitions PAGEREF _Toc51594020 \h 176Table of Figures TOC \h \z \c "Figure" Figure 1: Consult Toolbox Data Flow PAGEREF _Toc51594021 \h 4Figure 2: Enable Consult Toolbox Menu Option PAGEREF _Toc51594022 \h 5Figure 3: SEOC Database Unreachable Message PAGEREF _Toc51594023 \h 5Figure 4: About Consult Toolbox PAGEREF _Toc51594024 \h 6Figure 5: Consult Toolbox Preferences Window PAGEREF _Toc51594025 \h 7Figure 6: Add Comment to Consult Options PAGEREF _Toc51594026 \h 8Figure 7: Discontinue Consult Options PAGEREF _Toc51594027 \h 8Figure 8: Receive Consult Options PAGEREF _Toc51594028 \h 9Figure 9: Other User Settings Tab PAGEREF _Toc51594029 \h 10Figure 10: Consult Tracking… Menu Options PAGEREF _Toc51594030 \h 12Figure 11: Receive Menu Options PAGEREF _Toc51594031 \h 12Figure 12: Discontinuing Consult Menu Option PAGEREF _Toc51594032 \h 13Figure 13: Forward Menu Options PAGEREF _Toc51594033 \h 13Figure 14: Add Comment Menu Options PAGEREF _Toc51594034 \h 13Figure 15: Significant Findings Menu Option PAGEREF _Toc51594035 \h 14Figure 16: Administratively Complete Menu Option PAGEREF _Toc51594036 \h 14Figure 17: Receive Routine Consult Options Window PAGEREF _Toc51594037 \h 15Figure 18: Low Risk Clinics Options PAGEREF _Toc51594038 \h 17Figure 19: Extra Scheduling Effort Options PAGEREF _Toc51594039 \h 17Figure 20: Receive Consult Dialog Box PAGEREF _Toc51594040 \h 18Figure 21: Receive Menu PAGEREF _Toc51594041 \h 18Figure 22: Receive Routine Consult Options Window PAGEREF _Toc51594042 \h 19Figure 23: Receive Unable to Schedule Window PAGEREF _Toc51594043 \h 21Figure 24: Receive Consult Dialog Box PAGEREF _Toc51594044 \h 21Figure 25: Receive Menu PAGEREF _Toc51594045 \h 22Figure 26: Unable to Schedule Window PAGEREF _Toc51594046 \h 22Figure 27: MSA Elig. Verification Tab PAGEREF _Toc51594047 \h 23Figure 28: Specific Eligibility Verified Menu Options PAGEREF _Toc51594048 \h 24Figure 29: Receive Consult Dialog Box PAGEREF _Toc51594049 \h 25Figure 30: Receive Menu PAGEREF _Toc51594050 \h 25Figure 31: MSA Elig. Verification Tab PAGEREF _Toc51594051 \h 26Figure 32: Administrative Screening PAGEREF _Toc51594052 \h 27Figure 33: CAN Score Fields Enabled PAGEREF _Toc51594053 \h 28Figure 34: MSA Elig. Verification Tab: Document Administrative Screening Section PAGEREF _Toc51594054 \h 29Figure 35: Administrative Screening (for use by community care staff only) Window PAGEREF _Toc51594055 \h 30Figure 36: Scheduling staff member you will alert: Field PAGEREF _Toc51594056 \h 31Figure 37: Document Administrative Screening Populated PAGEREF _Toc51594057 \h 31Figure 38: Consult Review Tab PAGEREF _Toc51594058 \h 32Figure 39: Request Approved Options PAGEREF _Toc51594059 \h 32Figure 40: Request Disapproved Options PAGEREF _Toc51594060 \h 33Figure 41: Clinical Review Method Menu Options PAGEREF _Toc51594061 \h 33Figure 42: Receive Consult Dialog Box PAGEREF _Toc51594062 \h 34Figure 43: Receive Menu PAGEREF _Toc51594063 \h 35Figure 44: Consult Review Tab PAGEREF _Toc51594064 \h 35Figure 45: Clinical Triage for Care Coordination PAGEREF _Toc51594065 \h 36Figure 46: Receive Consult Dialog Box PAGEREF _Toc51594066 \h 38Figure 47: Receive Menu PAGEREF _Toc51594067 \h 38Figure 48: Consult Review Tab PAGEREF _Toc51594068 \h 39Figure 49: Clinical Triage for Care Coordination PAGEREF _Toc51594069 \h 39Figure 50: New Clinical Triage Coordination Level PAGEREF _Toc51594070 \h 40Figure 51: Comment Added to Consult PAGEREF _Toc51594071 \h 41Figure 52: Authorization Tab PAGEREF _Toc51594072 \h 42Figure 53: Service Line Menu Options PAGEREF _Toc51594073 \h 42Figure 54: List of Active SEOCs PAGEREF _Toc51594074 \h 43Figure 55: Display SEOC PAGEREF _Toc51594075 \h 43Figure 56: Receive Consult Dialog Box PAGEREF _Toc51594076 \h 44Figure 57: Receive Menu PAGEREF _Toc51594077 \h 44Figure 58: Authorization Tab PAGEREF _Toc51594078 \h 45Figure 59: Consult Previously Sent to HSRM Warning Message PAGEREF _Toc51594079 \h 45Figure 60: DoD Tab PAGEREF _Toc51594080 \h 46Figure 61: DoD Urgency Menu Options PAGEREF _Toc51594081 \h 46Figure 62: Receive Consult Dialog Box PAGEREF _Toc51594082 \h 47Figure 63: Receive Menu PAGEREF _Toc51594083 \h 47Figure 64: DoD Tab PAGEREF _Toc51594084 \h 48Figure 65: MSA Pt Contacts PAGEREF _Toc51594085 \h 49Figure 66: Search by Provider Tab PAGEREF _Toc51594086 \h 51Figure 67: Search by Institution Tab PAGEREF _Toc51594087 \h 52Figure 68: Receive Consult Dialog Box PAGEREF _Toc51594088 \h 53Figure 69: Receive Menu PAGEREF _Toc51594089 \h 54Figure 70: MSA Pt Contacts Tab PAGEREF _Toc51594090 \h 54Figure 71: Appt Tracking Tab PAGEREF _Toc51594091 \h 55Figure 72: Appointment Date Calendar View PAGEREF _Toc51594092 \h 56Figure 73: Receive Consult Dialog Box PAGEREF _Toc51594093 \h 59Figure 74: Receive Menu PAGEREF _Toc51594094 \h 59Figure 75: Appt Tracking Tab PAGEREF _Toc51594095 \h 60Figure 76: SAR/RFS Tab PAGEREF _Toc51594096 \h 61Figure 77: Receive Consult Dialog Box PAGEREF _Toc51594097 \h 62Figure 78: Receive Menu PAGEREF _Toc51594098 \h 62Figure 79: SAR/RFS Tab PAGEREF _Toc51594099 \h 63Figure 80: Consult Completion Tab PAGEREF _Toc51594100 \h 64Figure 81: Records Received Menu Options PAGEREF _Toc51594101 \h 65Figure 82: Receive Consult Dialog Box PAGEREF _Toc51594102 \h 66Figure 83: Receive Menu PAGEREF _Toc51594103 \h 66Figure 84: Consult Completion Tab PAGEREF _Toc51594104 \h 67Figure 85: General Discontinuation Comments Tab PAGEREF _Toc51594105 \h 68Figure 86: Other Reason Options PAGEREF _Toc51594106 \h 69Figure 87: Comm Care Discontinuation Comments Tab PAGEREF _Toc51594107 \h 69Figure 88: Discontinue Consult Dialog Box PAGEREF _Toc51594108 \h 70Figure 89: Discontinuing Consult Menu PAGEREF _Toc51594109 \h 71Figure 90: Discontinue Consult Options PAGEREF _Toc51594110 \h 71Figure 91: Discontinue Consult Dialog Box PAGEREF _Toc51594111 \h 72Figure 92: Discontinuing Consult Menu PAGEREF _Toc51594112 \h 72Figure 93: Comm Care Discontinuation Comments Tab PAGEREF _Toc51594113 \h 73Figure 94: Forward to Community Care Options Tab PAGEREF _Toc51594114 \h 74Figure 95: Forward Consult Dialog Box PAGEREF _Toc51594115 \h 75Figure 96: Forward Consult Menu PAGEREF _Toc51594116 \h 75Figure 97: Forward to Community Care Options Window PAGEREF _Toc51594117 \h 76Figure 98: Calls and Letters Tab PAGEREF _Toc51594118 \h 77Figure 99: Add Comment to Consult Dialog Box PAGEREF _Toc51594119 \h 79Figure 100: Community Care Menu PAGEREF _Toc51594120 \h 79Figure 101: Calls and Letters Tab PAGEREF _Toc51594121 \h 80Figure 102: Viewing Consult History PAGEREF _Toc51594122 \h 81Figure 103: Sched/Rescheduling Efforts Tab PAGEREF _Toc51594123 \h 82Figure 104: Add Comment to Consult Dialog Box PAGEREF _Toc51594124 \h 83Figure 105: Community Care Menu PAGEREF _Toc51594125 \h 84Figure 106: Calls and Letters Tab PAGEREF _Toc51594126 \h 84Figure 107: Sched/Rescheduling Efforts Tab PAGEREF _Toc51594127 \h 85Figure 108: Community Care Eligibility Tab PAGEREF _Toc51594128 \h 86Figure 109: Search by Provider Tab PAGEREF _Toc51594129 \h 87Figure 110: Search by Institution Tab PAGEREF _Toc51594130 \h 88Figure 111: Add Comment to Consult Dialog Box PAGEREF _Toc51594131 \h 89Figure 112: Community Care Menu PAGEREF _Toc51594132 \h 90Figure 113: Calls and Letters Tab PAGEREF _Toc51594133 \h 90Figure 114: Community Care Eligibility Tab PAGEREF _Toc51594134 \h 91Figure 115: Receive Unable to Schedule Window PAGEREF _Toc51594135 \h 92Figure 116: Add Comment to Consult Dialog Box PAGEREF _Toc51594136 \h 93Figure 117: Community Care Menu PAGEREF _Toc51594137 \h 93Figure 118: Unable to Schedule Window PAGEREF _Toc51594138 \h 94Figure 119: MSA Elig. Verification Tab PAGEREF _Toc51594139 \h 95Figure 120: Specific Eligibility Verified Menu Options PAGEREF _Toc51594140 \h 95Figure 121: Add Comment to Consult Dialog Box PAGEREF _Toc51594141 \h 96Figure 122: Community Care Menu PAGEREF _Toc51594142 \h 97Figure 123: MSA Elig. Verification Tab PAGEREF _Toc51594143 \h 97Figure 124: Administrative Screening PAGEREF _Toc51594144 \h 99Figure 125: CAN Score Fields Enabled PAGEREF _Toc51594145 \h 100Figure 126: MSA Elig. Verification Tab: Document Administrative Screening Section PAGEREF _Toc51594146 \h 101Figure 127: Administrative Screening (for use by community care staff only) Window PAGEREF _Toc51594147 \h 102Figure 128: Scheduling staff member you will alert: Field PAGEREF _Toc51594148 \h 103Figure 129: Document Administrative Screening Populated PAGEREF _Toc51594149 \h 103Figure 130: Consult Review Tab PAGEREF _Toc51594150 \h 104Figure 131: Request Approved Options PAGEREF _Toc51594151 \h 104Figure 132: Request Disapproved Options PAGEREF _Toc51594152 \h 105Figure 133: Clinical Review Method Menu Options PAGEREF _Toc51594153 \h 105Figure 134: Add Comment to Consult Dialog Box PAGEREF _Toc51594154 \h 106Figure 135: Community Care Menu PAGEREF _Toc51594155 \h 107Figure 136: Consult Review Tab PAGEREF _Toc51594156 \h 107Figure 137: Clinical Triage for Care Coordination PAGEREF _Toc51594157 \h 108Figure 138: Add Comment to Consult Dialog Box PAGEREF _Toc51594158 \h 110Figure 139: Community Care Menu PAGEREF _Toc51594159 \h 110Figure 140: Consult Review Tab PAGEREF _Toc51594160 \h 111Figure 141: Clinical Triage for Care Coordination PAGEREF _Toc51594161 \h 112Figure 142: New Clinical Triage Coordination Level PAGEREF _Toc51594162 \h 113Figure 143: Comment Added to Consult PAGEREF _Toc51594163 \h 114Figure 144: Authorization Tab PAGEREF _Toc51594164 \h 114Figure 145: Service Line Menu Options PAGEREF _Toc51594165 \h 115Figure 146: List of Active SEOCs PAGEREF _Toc51594166 \h 115Figure 147: Display SEOC PAGEREF _Toc51594167 \h 116Figure 148: Add Comment to Consult Dialog Box PAGEREF _Toc51594168 \h 117Figure 149: Community Care Menu PAGEREF _Toc51594169 \h 117Figure 150: Authorization Tab PAGEREF _Toc51594170 \h 118Figure 151: Consult Previously Sent to HSRM Warning Message PAGEREF _Toc51594171 \h 118Figure 152: DoD Tab PAGEREF _Toc51594172 \h 119Figure 153: DoD Urgency Menu Options PAGEREF _Toc51594173 \h 119Figure 154: Add Comment to Consult Dialog Box PAGEREF _Toc51594174 \h 120Figure 155: Community Care Menu PAGEREF _Toc51594175 \h 120Figure 156: DoD Tab PAGEREF _Toc51594176 \h 121Figure 157: MSA Pt Contacts PAGEREF _Toc51594177 \h 122Figure 158: Search by Provider Tab PAGEREF _Toc51594178 \h 124Figure 159: Search by Institution Tab PAGEREF _Toc51594179 \h 125Figure 160: Add Comment to Consult Dialog Box PAGEREF _Toc51594180 \h 126Figure 161: Community Care Menu PAGEREF _Toc51594181 \h 127Figure 162: MSA Pt Contacts Tab PAGEREF _Toc51594182 \h 127Figure 163: Appt Tracking Tab PAGEREF _Toc51594183 \h 128Figure 164: Appointment Date Calendar View PAGEREF _Toc51594184 \h 129Figure 165: Add Comment to Consult Dialog Box PAGEREF _Toc51594185 \h 132Figure 166: Community Care Menu PAGEREF _Toc51594186 \h 132Figure 167: Appt Tracking Tab PAGEREF _Toc51594187 \h 133Figure 168: SAR/RFS Tab PAGEREF _Toc51594188 \h 134Figure 169: Add Comment to Consult Dialog Box PAGEREF _Toc51594189 \h 135Figure 170: Community Care Menu PAGEREF _Toc51594190 \h 136Figure 171: SAR/RFS Tab PAGEREF _Toc51594191 \h 136Figure 172: Consult Completion Tab PAGEREF _Toc51594192 \h 137Figure 173: Records Received Menu Options PAGEREF _Toc51594193 \h 138Figure 174: Add Comment to Consult Dialog Box PAGEREF _Toc51594194 \h 139Figure 175: Community Care Menu PAGEREF _Toc51594195 \h 139Figure 176: Consult Completion Tab PAGEREF _Toc51594196 \h 140Figure 177: Clinical Review Options PAGEREF _Toc51594197 \h 141Figure 178: Add Comment to Consult Dialog Box PAGEREF _Toc51594198 \h 143Figure 179: Community Care Menu PAGEREF _Toc51594199 \h 143Figure 180: Clinical Review Options PAGEREF _Toc51594200 \h 144Figure 181: Add Comment to Consult Dialog Box PAGEREF _Toc51594201 \h 145Figure 182: Community Care Menu PAGEREF _Toc51594202 \h 145Figure 183: Decision Support Tool Dashboard PAGEREF _Toc51594203 \h 146Figure 184: Significant Findings Update PAGEREF _Toc51594204 \h 147Figure 185: Update Significant Findings Dialog Box PAGEREF _Toc51594205 \h 148Figure 186: Significant Findings Menu PAGEREF _Toc51594206 \h 149Figure 187: Significant Findings Update PAGEREF _Toc51594207 \h 149Figure 188: Administratively Close PAGEREF _Toc51594208 \h 150Figure 189: Administratively Complete Dialog Box PAGEREF _Toc51594209 \h 151Figure 190: Administratively Complete Menu PAGEREF _Toc51594210 \h 151Figure 191: Administratively Close Dialog Box PAGEREF _Toc51594211 \h 152Figure 192: Receiving and Rescheduling Consult Options Window PAGEREF _Toc51594212 \h 155Figure 193: Extra Scheduling Effort Options PAGEREF _Toc51594213 \h 157Figure 194: Receive Consult Dialog Box PAGEREF _Toc51594214 \h 157Figure 195: Receive Menu PAGEREF _Toc51594215 \h 158Figure 196: Receiving and Rescheduling Consult Options Window PAGEREF _Toc51594216 \h 158Figure 197: Receive Community Care Functions: COVID-19 Priority Tab PAGEREF _Toc51594217 \h 160Figure 198: Receive Consult Dialog Box PAGEREF _Toc51594218 \h 161Figure 199: Receive Menu PAGEREF _Toc51594219 \h 162Figure 200: COVID-19 Priority Tab PAGEREF _Toc51594220 \h 162Figure 201: Receiving and Rescheduling Consult Options Window: VA Clinic Referrals Tab PAGEREF _Toc51594221 \h 164Figure 202: Extra Scheduling Effort Options PAGEREF _Toc51594222 \h 166Figure 203: Add Comment to Consult Dialog Box PAGEREF _Toc51594223 \h 166Figure 204: Community Care Menu PAGEREF _Toc51594224 \h 167Figure 205: VA Clinic Referrals Tab PAGEREF _Toc51594225 \h 167Figure 206: Receiving and Rescheduling Consult Options: Community Care Referrals Tab PAGEREF _Toc51594226 \h 169Figure 207: Add Comment to Consult Dialog Box PAGEREF _Toc51594227 \h 170Figure 208: Community Care Menu PAGEREF _Toc51594228 \h 171Figure 209: Community Care Referrals Tab PAGEREF _Toc51594229 \h 171Figure 210: Add Comment Community Care Functions: COVID-19 Priority Tab PAGEREF _Toc51594230 \h 172Figure 211: Add Comment to Consult Dialog Box PAGEREF _Toc51594231 \h 173Figure 212: Community Care Menu PAGEREF _Toc51594232 \h 174Figure 213: COVID-19 Priority Tab PAGEREF _Toc51594233 \h 174IntroductionThe Consult Toolbox (CTB) software was created by the Atlanta VA Medical Center (VAMC) in response to a need to manage the process of consult management. During the life of a consult, there are steps of actions to be taken, and there is a need to be able to track these steps at an individual patient level. Additionally, there is a need to be able to understand the overall status of consult management at a macro level, and identify specific services needing attention or resources. Without opening and reading a patient medical record, it is difficult to identify which Veterans have had which scheduling steps completed. This software does several things. First, it makes it very easy for staff to document actions completed quickly and consistently. Second, it uses consistent verbiage to document these steps. Third, it eliminates the need to take a second action or make a separate entry to track scheduling steps. Fourth, this consistent verbiage allows software analysis of records without needing to have software changes to Veterans Health Information Systems and Technology Architecture (VistA) or Computerized Patient Record System (CPRS). A separate process using Corporate Data Warehouse (CDW) queries and reports allows creation of views showing such things as Veterans who have not had first call, second call, scheduling letter sent or how much time has passed between these events. Together, these allow tracking and managing consults without the need to keep a separate list or other workflow to know which consults need attention.PurposeThe purpose of this document is to provide instruction for utilizing the Consult Toolbox to standardize and streamline consult management for Community Care.Document OrientationThe Consult Toolbox User Guide will provide explanations of each screen and of all user interface options within the context of an easy to understand demonstration data scenario. This document is also designed to provide the user with screen-by-screen “how to” information on the usage of Consult anization of the ManualSection 1: IntroductionThe Introduction section provides the purpose of this manual, an overview of the Consult Toolbox software, an overview of the software used, project references, contact information for the user to seek additional information, and an acronyms and abbreviations list for this manual.Section 2: System SummaryThe System Summary section provides a graphical representation of the equipment, communication, and networks used by the system, user access levels, how the software will be accessed, and contingencies and alternative modes of operation.Section 3: Getting StartedInformation for the Getting Started section provides a general walk-through of the system from initiation through exit, enabling the user to understand the sequence and flow of the system.Section 4: Using the SoftwareThis section gives the user the “how to” information to use Consult Toolbox, including many step-by-step procedures.Section 5: TroubleshootingThis section provides troubleshooting for the Consult Toolbox user.Section 6: Acronyms and AbbreviationsThis section provides a list of acronyms and abbreviations found in this document.AssumptionsThe user must have login credentials for CPRS.CoordinationN/ADisclaimersSoftware DisclaimerThis software was developed at the Department of Veterans Affairs (VA) by employees of the Federal Government in the course of their official duties. Pursuant to title 17 Section 105 of the United States Code this software is not subject to copyright protection and is in the public domain. VA assumes no responsibility whatsoever for its use by other parties, and makes no guarantees, expressed or implied, about its quality, reliability, or any other characteristic. We would appreciate acknowledgement if the software is used. This software can be redistributed and/or modified freely provided that any derivative works bear some notice that they are derived from it, and any modified versions bear some notice that they have been modified.Documentation DisclaimerThe appearance of external hyperlink references in this manual does not constitute endorsement by the Department of Veterans Affairs (VA) of this Web site or the information, products, or services contained therein. The VA does not exercise any editorial control over the information you may find at these locations. Such links are provided and are consistent with the stated purpose of the VA.Documentation ConventionsThis manual uses several methods to highlight different aspects of the material.Table SEQ Table \* ARABIC 1. Documentation Symbols and DescriptionsSymbolDescriptionCAUTION: Used to caution the reader to take special notice of critical information.Notes are used to inform the reader of general information including references to additional reading material.References and ResourcesReaders who wish to learn more about CPRS and Consult Toolbox should consult the following:CPRS: Consult/Request Tracking in the VDL: Enterprise Service Desk and Organizational ContactsFor issues related to the Consult Toolbox that cannot be resolved by this manual or the site administrator, please contact the Enterprise Service Desk at 855-NSD-HELP (673-4357).System SummarySystem ConfigurationThe Consult Toolbox software installs at the Windows level and resides in the system tray. It watches keyboard and mouse activity and comes to life when certain conditions occur. The first is it only activates when the currently active windows title Add Comment to Consult, Forward Consult, Discontinue Consult, Administratively Complete, Receive Consult, Update Significant Findings, or WIN+V. Otherwise it does nothing.The second is when the user initiates a trigger event when either of these windows have the focus, then depending on the open window a menu appears for the user to select the appropriate action, then the software inserts the appropriate text into the comment box.The defined trigger is a right mouse click in the supported CPRS consult actions.Data FlowsThe figure below displays the Consult Toolbox data flow between CPRS and SEOC.Figure SEQ Figure \* ARABIC 1: Consult Toolbox Data FlowUser Access LevelsThe User must have access to CPRS to access Consult Toolbox. Continuity of OperationConsult Toolbox falls under the VistA Continuity of Operations Plan. Getting StartedThis section provides a general walkthrough of Consult Toolbox from initiation through exit. Accessing Consult ToolboxIf you are unable to access/use Consult Toolbox, see the Troubleshooting section in this document or contact the National Service Desk at 855-NSD-HELP (673-4357).Enabling Consult ToolboxBefore enabling Consult Toolbox in CPRS, you will need to run the ConsultToolbox.exe file. The file can be found in the following location: <C:\Program Files\ConsultToolBox\ConsultToolbox.exe>.Consult Toolbox is part of the CPRS system which requires both a user name and password. On the first use, Consult Toolbox will be disabled until you enable through the CPRS Tools menu. Once enabled, you’ll want to set your preferences. The Consult Toolbox should be enabled on the applicable computer (this only needs to be done once on a given computer for each person).When installed on the PC, it will be installed on the workstation as an installed program, but it will need to be enabled. This should be set up on the CPRS Tools menu. Below is an example of how it might, look, but depending on how the station Clinical Application Coordinators (CAC) set-up the tool, the enable link may be in some other location on the tool bar, so each station may look different.Figure SEQ Figure \* ARABIC 2: Enable Consult Toolbox Menu OptionSelecting Enable Consult Toolbox will activate the Toolbox so it will open automatically each time Windows is opened. It only needs to be done once for a given PC and enabled; the Consult Toolbox will be active each time you log into this computer. When changing computers, the user will need to enable it on the new computer. It will remain enabled from then on, until it is disabled. In the event the Consult Toolbox seems to not be working correctly, enable it again and it will reset. If SEOC database is unavailable the following warning displays. SEOCs previously downloaded will still be available on the Authorization tab. Contact the NSD if no SEOCs are available.Figure SEQ Figure \* ARABIC 3: SEOC Database Unreachable MessageSetting Consult Toolbox PreferencesThe Settings functionality within the Consult Toolbox provides any user the ability to select their default features upon opening the Toolbox based on their roles and responsibilities. To update your Consult Toolbox settings, follow the steps listed below:Press the Windows + V key. Once these keys are pressed, the About Consult Toolbox dialog box opens.Figure SEQ Figure \* ARABIC 4: About Consult Toolbox Click Settings to set the preferences. The Consult Toolbox Preferences and Settings window opens.Clicking OK will close the dialog box and otherwise do nothing. The Reload CTB resets the Consult Toolbox and can also be used to recover from a technical glitch. Figure SEQ Figure \* ARABIC 5: Consult Toolbox Preferences WindowThe Consult Toolbox Preferences and Settings window also displays the Consult Toolbox Version number. Select the Automatically Open Toolbox tab.From the Enable Consult Toolbox section, select Yes or No. Yes – this makes the Consult Toolbox function. By enabling it, a link to the Consult Toolbox is placed in the Windows Start Up folder, so the consult toolbox is active each time you log into this PC.No – this removes any link from the Startup Menu and turns off the Consult Toolbox. After selecting this option, the Consult Toolbox will no longer function. It will need to be enabled once again from the CPRS Tools menu.Select the Use automation settings below. check box to automate settings, otherwise the automation functionality will be disabled.From the Add Comment to Consult Options: drop-down menu, select the preferred add comment to consult option.Figure SEQ Figure \* ARABIC 6: Add Comment to Consult OptionsDo not open Consult Toolbox: Nothing will happen when the CPRS add comment box opens.Show menu: As soon as the Add Comment to Consult box opens, the shortcut menu will show itself for the user to select. The user may select an option, or doing something else, including clicking in the white space of the box, will cause the shortcut menu to disappear.Scheduler Options: As soon as the Add Comment to Consult pop-up box appears, the Consult Toolbox screen for in-house VA schedulers will also appear. Community Care Options: As soon as the Add Comment to Consult pop-up box appears, the Community Care screen for the Consult Toolbox will also appear. This is the same screen that appears under Community Care Options on the Receive Consult CPRS box.Provider Options: As soon as the Add Comment to Consult dialog box opens, the provider review screen will appear.For VA in-house consult schedulers, the recommended setting is Scheduler Options. For Community Care staff (clinical and administrative), the recommended setting is Community Care Options and for in-house clinicians, the recommended setting is Provider Options.From the Discontinue Consult Options: drop-down menu, select the preferred discontinue consult option.Figure SEQ Figure \* ARABIC 7: Discontinue Consult OptionsDo not open Consult Toolbox: Nothing will happen when the CPRS discontinue box opens.Show menu: As soon as the Discontinue Consult window opens, the shortcut menu will show itself for the user to select. The user may select an option, or doing something else, including clicking in the white space of the box, will cause the shortcut menu to disappear.Show Toolbox: As soon Discontinue Consult window opens, the Consult Toolbox discontinue consult screen also appears.From the Receive Consult Options: drop-down menu, select the preferred receive consult option. Figure SEQ Figure \* ARABIC 8: Receive Consult OptionsDo not open Consult Toolbox: Nothing will happen when the receive consult box opens. Show menu: As soon as the Receive Consult box opens, the shortcut menu will show itself for the user to select. The user may select Receive Consult or select something else. Clicking in the white space of the box, will cause the shortcut menu to disappear.Receive Consult: As soon as the Receive Consult box appears, the Receive Consult screen for the Consult Toolbox will also appear. Community Care Options: As soon as the Receive Consult box appears, the Community Care screen for the Consult Toolbox will also appear. Note, this is the same screen appears under Community Care Options on the Add Comment to Consult CPRS box.Select the Other User Settings tab.Figure SEQ Figure \* ARABIC 9: Other User Settings TabSelect the check boxes for the preferred settings.Check if you are a clinical staff member – This is pertinent only under the Community Care screen. If the user can make clinical assessments or decisions in the management of community care, select yes for this option. Staff selecting yes are typically nurses and licensed practitioners. This check box must be selected to see the COVID-19 Priority tab in the Community Care Functions screen.Check if you want the low risk option on Receive Consult screen – Veterans Health Administration (VHA) has defined low risk clinics nationally to include: physical therapy, occupational therapy, kinesiotherapy, acupuncture, smoking clinic, MOVE clinic, massage therapy, chiropractic care and erectile dysfunction clinic. A full list of low risk clinics can be found in the VHA Consult SOP. As soon as the Receive Consult box appears, the Receive Consult screen for the Consult Toolbox for low risk clinics will also appear. Note that to use this option, a clinic must be approved as a low risk clinic by the facility consult management (Committee or Chief of Staff (COS) designee). Enable color features – If checked, certain screens will have some headings and selected tabs with color highlights instead of being in black, white and grey. The screen image above shows how the tabs look with color highlight off. Enable audible tabs – Reads aloud the community care comments panel tab name.CAN URL: - The Preferred Care Assessment Need (CAN) Universal Record Location (URL) should only be changed if directed by support personnel. The URL and certificate name can be changed by support to suit the execution environment.Client Cert: The name of the internet browser certificate that will be used to contact the CAN score server online. Facility & Services: - The URL used to access VA Community Care Provider Locator.SEOC URL: - The Preferred SEOC URL should only be changed if directed by support personnel. The URL and certificate name can be changed by support to suit the execution environment.State: Enter the state you typically use for community care providers. This will be the default setting any time you look up a provider for community care. You can always change it.Enable Delegation of Authority for administrative authorized processing – The Delegation of Authority is an action taken by the Chief of Staff to delegate clinical review authority for services that are requested through a community care consult. If this process was implemented in your facility, check this box.Enable consult screening and triage options – At the time of this version, local community care staff will have the ability to assign care coordination levels based on a Veterans complexity of needs. Check this box to begin using this functionality. Enable COVID-19 workflow for Receive Consult and Clinical Review options – Check this box to access the screens required for use during the Coronavirus Disease of 2019 (COVID-19) Pandemic.For instructions on how to access the new screens during the COVID-19 Pandemic, please refer to REF _Ref37758178 \h \* MERGEFORMAT Appendix A: Management of Consults when COVID-19 Workflow is Enabled.Click Exit and Save Changes to save the selected settings for future work sessions.System MenuThe Action>Consult Tracking… menu in CPRS offers several Consult Toolbox functions: Receive, Discontinue, Forward, Add Comment, Significant Findings, and Administrative Complete.Figure SEQ Figure \* ARABIC 10: Consult Tracking… Menu OptionsReceiveFigure SEQ Figure \* ARABIC 11: Receive Menu OptionsDiscontinueFigure SEQ Figure \* ARABIC 12: Discontinuing Consult Menu OptionForwardFigure SEQ Figure \* ARABIC 13: Forward Menu OptionsAdd CommentFigure SEQ Figure \* ARABIC 14: Add Comment Menu OptionsSignificant FindingsFigure SEQ Figure \* ARABIC 15: Significant Findings Menu OptionAdministrative CompleteFigure SEQ Figure \* ARABIC 16: Administratively Complete Menu OptionUsing the SoftwareThe Consult Toolbox provides user functionality in the following consult windows: Receiving Consult Activities — this can be configured to open automatically.Discontinuing Consult — this can be configured to open automatically.Forwarding Consult to Community Care – right-click in comment required, only for forwarding to community care.Adding Comment to Consult — this can be configured to open automatically.Significant Findings – right-click required, may be used when needing to convey a message to the ordering provider, though a progress note should also be present with more detail.Administratively Close Consult — right-click in comment required, only for instances where community care was completed, but records are unavailable.For a list of Health Factors that are used in Consult Toolbox, please refer to REF _Ref37753117 \h \* MERGEFORMAT Appendix B: Consult Factor Types and Definitions.Receiving Consult ActivitiesReceiving FunctionsFor instructions on how to receive consults during the COVID-19 Pandemic please refer to REF _Ref39064007 \h \* MERGEFORMAT Appendix A1: Receiving Consult Activities when COVID-19 Workflow is Enabled.Clinicians and/or delegated administrative staff receive View Alert in CPRS/ of VA order/consult notification. When a provider receives a pending consult, review should include determination of whether the consult is appropriate to be scheduled, and optionally, additional direction can be given to the scheduler.The Receiving Consult Activities is used by any clinic in the VA facility that receives a consult. This clinic may be an internal VA clinic or a community care clinic.Figure SEQ Figure \* ARABIC 17: Receive Routine Consult Options WindowReceive Routine Consult Options sectionAccept consult, schedule routine appointment – Accept consult, schedule within one month, ok to overbook—the reviewing provider has determined that the Veteran’s medical condition warrants them being seen within one month and should be overbooked if needed to accomplish that effect.Accept consult, schedule within 1 month (OK to overbook) – Accept consult schedule within two weeks, ok to overbook—the reviewing provider has determined that the Veteran’s medical condition warrants them being seen within two weeks and should be overbooked if needed to accomplish that effect.Accept consult, schedule within 2 weeks, (OK to overbook) – Accept consult schedule within one week ok to overbook—the reviewing provider has determined that the Veteran’s medical condition warrants them being seen within one week and should be overbooked if needed to accomplish that effect. If less than one week or immediate, the provider may add additional instructions, or speak directly with the scheduler if truly urgent.Accept consult, schedule within 1 week, (OK to overbook) – Accept consult schedule on a specific date—this allows the provider to specify the date to see the Veteran. Accept consult, schedule on MM/DD/YYYY, (OK to overbook) – Accept consult see scheduling order for scheduling instructions—this selection applies if the clinic or service provider prefers to convey scheduling instructions via a CPRS order. Accept consult; see scheduling order for scheduling instructions – this selection applies if the clinic or service provider prefers to convey scheduling instructions via CPRS order. Established pt., please schedule then discontinue consult – this selection applies if a consult is received for an established patient. Once the consult is received, it is sent to the scheduler to make the appointment. Once the appointment is made, the consult can be discontinued. If no appt. slot is available within 30 days:Forward to Community Care OfficeDiscuss with clinical staffAdditional comments and instructions sectionThis consult may be D/C’d after mandated scheduling effort—this option allows the reviewing provider to determine at the time of acceptance that if the staff is unable to get the appointment scheduled, or if the Veteran cancels or no-shows twice, then the consult can be discontinued by the scheduler without having another clinical review. The consult is returned to the ordering provider to take whatever action deemed appropriate. The This consult may be discontinued d/c’d after 1 missed appointment (approved low risk clinic) check box described below is only visable when enabled in the Consult Toolbox Settings.This consult may be discontinued d/c’d after 1 missed appointment (approved low risk clinic) – An additional option for low risk clinics exists for discontinuation after one missed appointment. This screen auto populates from settings described above.Figure SEQ Figure \* ARABIC 18: Low Risk Clinics OptionsScheduling plans discussed with ordering provider—this selection is simply for the convenience of the reviewing provider to document the instance where they have discussed the case with the ordering provider. This allows them to easily document that conversation took place. It doesn’t have any significant ramifications with respect to consult processing.Consults should be marked “High Risk” for track and extra scheduling effort sectionHigh Risk Consult-Extra scheduling effort warranted – this will flag this consult as having a medically high-risk condition that warrants additional calls to the Veteran beyond the mandated minimum necessary effort. It also allows the receiving service to flag certain consults for closer follow up when the Veteran fails to keep appointments. Each service may define what high risk means to them. This is simply a way of segregating higher risk consults from the rest and notifying the staff to expend additional effort.Extra scheduling effort – allows the reviewer to specify what additional effort they would like. In addition to the selection of options, the user may type in other instructions.Figure SEQ Figure \* ARABIC 19: Extra Scheduling Effort OptionsFor Schedulers Who Receives Consults section, First call to Veteran (unsuccessful scheduling) – This option supports recording calls to Veteran that were successful. Unable to Contact letter sent to Veteran – use this selection when a letter is sent to the Veteran indicating that the clinic has tried to reach the Veteran to schedule an appointment. This comment may be used each time a letter is sent, if sent more than once.Letter Sent by Certified Mail – in the case of high risk consults, business rules for the clinic or upon suggestion of the provider, it may be appropriate to send the Veteran a certified letter indicating that they have a potentially serious condition, and that the VA has been unsuccessful reaching them to provide care. Receiving Consult StepsTo receive consult, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 20: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 21: Receive MenuFrom the Receive menu, select Receive Consult. The Receive Routine Consult Options window opens.Figure SEQ Figure \* ARABIC 22: Receive Routine Consult Options WindowFrom the Receive Routine Consult Options section, select the consult option. Accept consult, schedule routine appointment is the default process. The appointment will be scheduled according to routine scheduling instructions. Routine scheduling means that the Veteran will be given the next open appointment. If that appointment exceeds the wait time standard, the Veterans Community Care Program (VCCP) will be an option available to the Veteran. Subsequent radio buttons under the receive consult options provide guidance to keep the Veteran in-house and overbook.If the Veteran is an established patient, then select the Established pt., please schedule then discontinue consult check box.If an appointment is not available for the Veteran within 30 days, select Forward to Community Care Office or Discuss with clinical staff from the If no appt. slot is available within 30 days: drop-down menu.From the Additional comments and instructions section, select the options that best apply to this consult.If the consult is high risk and needs to be tracked and extra scheduling efforts, select the High Risk Consult-Extra scheduling effort warranted check box from the Consults should be marked “High Risk” for track and extra scheduling effort section. If the consult is high risk, from the Extra scheduling effort select the option that to specify what additional effort you would like. In addition to the selection of options, you may type in other instructions.From the For Schedulers Who Receives Consults: section, select if a call was made to the Veteran or if a letter was sent was sent to the Veteran. Select the Letter Sent by Certified Mail check box if a certified letter was sent to the Veteran.Click OK. Unable to Schedule FunctionsThe Unable to Schedule function is the replacement for Veterans awaiting care via the EWL in VistA. The use of the Unable to Schedule function should not be used for administrative transfer requests. The use of the Light Electronic Action Framework (LEAF) should be used for administrative transfer requests. Staff who receive and schedule internal VA consults are required to activate and utilize the Consult Toolbox when available to document reasons that consults cannot be scheduled and to monitor these requests for care. Unable to Schedule consults should remain in an Active status until the patient is scheduled or care is delivered.Providers and schedulers will only use this option when receiving an internal VA consult that cannot be scheduled 390 days in the future and the Veteran has already declined Community Care or there is no comparable service in the community. Right clicking the text area while receiving a consult or when adding a comment will bring up the list of approved reasons. Selecting one or more of these reasons will provide standard text that may be inserted in the consult comments to document why the consult cannot be appropriately scheduled.Figure SEQ Figure \* ARABIC 23: Receive Unable to Schedule WindowPrefers VA/No Capacity – Wants VA care (opts out of Community Care) and is waiting for availability. Care need is not met.No Comparable Service in the Community – Service is unique to VA this is specific to GEC, Home Base Primary Care (HBPC), and Mental Health services, where the care is not offered in the community (e.g., Spinal Cord Injury, Purchased GEC Care, HBPC with no VA Primary Care).Receiving Care/Awaiting Specialized Service – Care needs being met in VA while waiting for specialized VA service (e.g., HBPC Patients receiving VA Primary Care).Unable to Schedule StepsIf the consult is unable to schedule , follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 24: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 25: Receive MenuFrom the Receive menu, select Unable to Schedule. The Unable to Schedule window opens.Figure SEQ Figure \* ARABIC 26: Unable to Schedule WindowFrom the Unable to Schedule section, select one or more reasons you were unable to schedule the consult.Click OK.If you click OK before selecting an option, you will receive an error message stating that you must make a selection to munity Care FunctionsFor instructions on how to assign priority during the COVID-19 Pandemic please refer to REF _Ref39063802 \h \* MERGEFORMAT Appendix A1.3: Receive Community Care Functions: COVID-19 Priority and REF _Ref39063803 \h \* MERGEFORMAT Appendix A2.3: Add Comment Community Care Functions: COVID-19 munity Care functions document activities that have taken place within the Community Care programs that are provided by the VA. When compiling pertinent medical documentation for upload to the TPA Portal, it is highly recommended that the Referral Documentation Tool (REFDOC) be used. REFDOC is an innovative solution that extracts from the Veteran’s electronic medical record and records into PDF format for exchange with community care providers. REFDOC improves the timeliness of medical record transfers by allowing VA staff to quickly extract Veterans’ health information from Veterans Health Information Systems and Technology Architecture (VistA), Computerized Patient Record System (CPRS), and Corporate Data Warehouse (CDW) and compile it into a PDF package that can be easily shared with community providers.MSA Eligibility VerificationFigure SEQ Figure \* ARABIC 27: MSA Elig. Verification TabSpecific Eligibility Verified—allows staff to further signify that the Veteran is eligible under one of the administrative eligibilities. This option allows the user to identify Community Care eligibility. The drop-down offers the following options:Figure SEQ Figure \* ARABIC 28: Specific Eligibility Verified Menu OptionsBMI-HardshipBMI-per episode of careDrive TimeGrandfathered under ChoiceNo Full Service VA Available in State1703 (e) EligibilityService Not AvailableWait Time – VA appointment is not available within the wait time standard.*Grandfathered eligibility from Veterans Choice Program.Presumed eligible, HEC Update Pending —This is typically appropriate when a new Veteran is being registered and all evidence indicates (e.g. a DD 214 form) that the person is indeed a Veteran, but the eligibility cannot be verified by the Health Eligibility Center’s (HEC) systems. This is an indication that the record requires action by the HEC before the consult can move forward. Unable to Verify Eligibility —Staff member should take steps to verify eligibility. Staff is unable to verify the person’s eligibility for VA care or Community Care. This allows documentation of that fact and alerts the staff to refer the case to the appropriate person for resolution. A comment is available for further clarification but is not mandatory.Delegation of Authority Medical Services List Reviewed section. — This allows staff to select if clinical review is required, by checking a box.Clinical review requiredDoes not require clinical reviewDocument Administrative ScreeningCommunity Care MSA Eligibility Verification StepsTo set the Community Care MSA Eligibility Verification options, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 29: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 30: Receive MenuFrom the Receive menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Figure SEQ Figure \* ARABIC 31: MSA Elig. Verification TabSelect the Specific Eligibility Verified, Presumed eligible, HEC Update Pending, or Unable to Verify Eligibility check box that best describes the Community Care MSA eligibility verification.CAUTION: Staff must contact local enrollment and eligibility office before proceeding.Once you have contacted local enrollment and eligibility, select the best option from the Delegation of Authority Medical Services List Reviewed section. Information under Document Administrative Screening is populated and provides care coordination information about this Veteran. Additional details are in Community Care Document Administrative Screening and Clinical Triage tool section.Click munity Care (CC) Document Administrative ScreeningThe Screening/Triage tool enables staff to assess the Veteran’s care coordination needs in the community. The tool consists of an administrative screening and clinical triage sections. While the administrative section may be completed by any integrated team staff member (MSA/PSA, Social Worker, RN), the clinical section may be only completed by clinical staff. The administrative section consists of questions about the urgency of the Veteran’s care request, the requested services in the consult, and the corresponding Veteran CAN (Care Assessment Need) score, accessible through VSSC. Based on the answers in this section, the tool will determine whether a clinical assessment will be necessary. If so, the tool will prompt the user to input the name of the RN responsible for completing the clinical section and send an alert. Figure SEQ Figure \* ARABIC 32: Administrative ScreeningAdministrative Screening for Care Coordination and Case Management section:Are you a clinical staff member: Yes or No—the first question asks if you are a clinical staff member. This box will screen to see if clinical staff needs to review an alert, which wouldn’t be needed if the user is a clinical staff person.Urgency: is appointment needed within 48 hours—if urgent care coordination is required, this should be forwarded immediately for clinical triage. (If within 48 hours, skip remaining questions and forward for clinical triage.)Does the consult specify any of the following complex conditions or services? — if the consult specifies any complex conditions or services, select one of the following options from the drop-down menu.New Cancer DiagnosisOutpatient SurgeryCoronary Artery Bypass (CABG)Chronic Heart FailureChronic Obstructive Pulmonary Disease/PneumoniaInpatient Hospitalization (any cause)None of the aboveDoes the consult specify any of the following basic services — if the consult specifies basic services, select the applicable service from the drop-down menu.Routine therapeutic services (Dialysis, OT, PT, RT)Routine MammographyCervical Ca Screening (PAP Test)Complimentary and integrated medicineDirect SchedulingRoutine Screening ColonoscopyLow Dose CT ScansNone of the aboveCAN Score — CAN Scores serve as an important component to the Screening/Triage process providing a standardized evidence-based measure of Veteran risk. CAN Scores measure the probability of inpatient admission or death within a specified period of time (1 year) in percentage form. Toolbox automatically retrieves the CAN Score for a patient from the CDW via the CAN Score service.If the CAN Score service is unavailable or a CAN Score does not exist for a patient, manual entry of the CAN Score is enabled. Figure SEQ Figure \* ARABIC 33: CAN Score Fields EnabledTo access a Veteran’s CAN Score manually, the staff will be required to access VHA Support Service Center (VSSC). If CAN (Care Assessment Needs) Score is known, make the appropriate selection, or if not available, select No CAN Score Available from the following choices: 0 to 7475 to 90Over 90No CAN Score AvailableCAN Score for: - Name of Veteran.DOB: - Veteran’s date of birth.SSN: - Veteran’s social security number.CAN Score: - Veteran’s CAN Score.Current Coord Level Assessment: - If this is not Basic, a box will open to input the name of the clinical staff member responsible for completing the clinical triage portion of the tool. This is not shown for clinical staff. This does not send the actual alert, the user is responsible for sending the alert using the Send additional alerts button on the comment screen:Clinical Triage: - If the level of care coordination determined in the administrative screening section is not basic, the administrative staff member will alert a clinical care coordinator to complete the clinical triage section below. The clinical section consists of questions regarding the Veteran’s comorbidities, social factors, and need for assistance with Activities of Daily Living (ADLs). There is also a drop-down menu which the clinical care coordinator may fill out to override the results of the tool using clinical evidence-based judgment.If clinical triage has already been performed, it will show. Also, if care coordination has already been assigned by Administrative screening (as in the example below) that will also show.Scheduling staff member you will alert: - Name of the scheduling staff member.Remember staff person for next referral: - option that tells the Consult Toolbox to remember the selected scheduling staff person for the next munity Care (CC) Document Administrative Screening StepsTo set the Document Administrative Screening options, follow the steps listed below:Figure SEQ Figure \* ARABIC 34: MSA Elig. Verification Tab: Document Administrative Screening SectionFrom the MSA Elig. Verification tab, click Document Administrative Screening. The Administrative Screening (for use by community care staff only) window opens. Figure SEQ Figure \* ARABIC 35: Administrative Screening (for use by community care staff only) WindowIf clinical review has already been performed, it will show. If administrative screening has been performed on this consult previously, it will be indicated as such in the administrative screening section.Select the Yes or No radio button for the From the Are you a clinical staff member question.Select the Yes or No radio button if there is an urgency to have an appointment in the next 48 hours.From the Does the consult specify any of the following complex conditions or services? drop-down menu, select if the consult specifies any complex conditions or services.Either a complex or basic service may be selected from the drop-down menus but not both, if both are selected the first selection will be reset to “None of the above”.From the Does the consult specify any of the following basic services? drop-down menu, select the applicable service.From the CAN Score section, select appropriate selection with regards to the CAN Score. If the Current Coord Level Assessment is not Basic, input the name of the clinical staff member responsible for completing the clinical triage portion of the tool in the Name of scheduling staff member you will alert: field. This is not shown for clinical staff. Figure SEQ Figure \* ARABIC 36: Scheduling staff member you will alert: FieldSelect the Remember staff person for next referral check box if you would like Consult Toolbox to remember your selection for the next referral.This does not send the actual alert, the user is responsible for sending the alert using the Send additional alerts button on the comment screen:Click OK. The Document Administrative Screening information will populate on the MSA Elig. Verification tab.Figure SEQ Figure \* ARABIC 37: Document Administrative Screening PopulatedConsult ReviewFigure SEQ Figure \* ARABIC 38: Consult Review TabCommunity Care Clinical Review (for use by community care staff only)Request Approved (Select CC Program)— Optional field. Various Community Care programs can be selected but must be one of the listed in the drop-down menu.Figure SEQ Figure \* ARABIC 39: Request Approved OptionsIf you are located in Alaska , Tribal will be an additional option in the Request Approved (Select CC Program) drop-down menu.The Request Approved (Select CC Program) list is intended to display the approved program authorities used to purchase care in the ment:Request disapproved (reason) —reason request disapproved, enter other reason in the field or select an option from the Opt menu.Figure SEQ Figure \* ARABIC 40: Request Disapproved OptionsNot Medically NecessaryDuplicate ConsultService available at the VAOther VA Providing CareIncomplete Information Not a Covered ServiceClinical Review Method: Figure SEQ Figure \* ARABIC 41: Clinical Review Method Menu OptionsMCG GuidelinesInterQual CriteriaChief of Staff approved ProtocolHardship Request Approval: Is this a Community Care-Hardship Determination consult?Request Approved by COS or by his or her designeeApproved for 6 monthsApproved for 12 monthsRequest Disapproved by COS or by his or her designee Provider may authorize discontinuation after failure of mandated scheduling effort without further clinical reviewMay discontinue if Veteran cancels/no-shows or fails to respond to mandated scheduling effort — If the Provider authorizes discontinuation after failure of mandated scheduling effort without further clinical review.twiceonceIs responsible for schedulingVA Staff VA schedules based on Veteran’s preferenceVeteran self-schedulesCommunity provider schedules directly with VeteranCommunity Care ContractorDocument Clinical TriageConsult Review StepsTo set the CC Consult Review options, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 42: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 43: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Consult Review tab.Figure SEQ Figure \* ARABIC 44: Consult Review TabFrom the Community Care Clinical Review section, select if the request was approved or disapproved. If the request was approved, you will need to select the CC Program from the drop-down. If the request was not approved, you will need to select the reason from the Opt menu.From the Hardship Request Approval section, select the best options.If the Provider authorizes discontinuation after failure of mandated scheduling effort without further clinical review, select May discontinue if Veteran cancels/no-shows or fails to respond to mandated scheduling effort check box and select the number of times from the drop-down menu.From the Is responsible for scheduling section, select if the scheduling will be done by either VA Staff or Community Care Contractor.Click OK.Clinical TriageIf the level of care coordination determined in the administrative screening section is not basic, the administrative staff member will alert a clinical care coordinator to complete the clinical triage section below. The clinical section consists of questions regarding the Veteran’s comorbidities, social factors, and need for assistance with Activities of Daily Living (ADLs). There is also a drop-down menu which the clinical care coordinator may fill out to override the results of the tool using clinical evidence-based judgment.If clinical triage has already been performed, it will show. Also, if care coordination has already been assigned by Administrative screening that will also show.Figure SEQ Figure \* ARABIC 45: Clinical Triage for Care CoordinationClinical Care Coordination AssignmentThe Screening/Triage tool will recommend a care coordination level once the following items are populated:Veteran Comorbidities:—select yes or no if based on your review of Veteran information and clinical judgement if the Veteran will require additional care coordination/support during this episode of care due to two or more comorbidities.Psychosocial Factors:—select yes or no if based on your review of the Veteran information and clinical judgement, if the Veteran will require additional care coordination/support during this episode of care due to any psychosocial factors (e.g. Dementia, Depression, Homelessness, Lack of Caregiver Support).Activities of Daily Life, or ADL support: –select yes or no if based on your review of Veteran information and clinical judgement, if the Veteran will require ADL support.New Calculated Assessment: — the tool will calculate a level of care coordination based on the answers in the administrative screening and clinical triage sections as displayed below:Based on review of Veteran information and clinical judgement, the level of care coordination should be manually adjusted to: - Based on clinical judgment, the clinical care coordinator may override the automated result. If manual adjustment is required for the level of care coordination, select the revised level in the drop-down menu along with the reason for adjustment in the textbox below.BasicModerate ComplexUrgentReasons for manual adjustment of care coordination level — enter a clinical reason for manually changing care coordination level.Final Clinical Triage Coordination Level: - auto-populates based on the completion of clinical triage questions or manual override. Name of scheduling staff member: - Name of the scheduling staff member.Remember staff person for next referral – option that tells the Consult Toolbox to remember the selected staff person for the next referral.Clinical Triage StepsTo complete the clinical triage, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 46: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 47: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the CC Consult Review tab.Figure SEQ Figure \* ARABIC 48: Consult Review TabClick the Document Clinical Triage button. The Clinical Triage for Care Coordination window opens.Figure SEQ Figure \* ARABIC 49: Clinical Triage for Care CoordinationThe Clinical Triage tool will recommend a care coordination level once the following items are populated.From the Veteran Comorbidities: section, select No or Yes if the Veteran will require additional care coordination/support during this episode of care due to two or more comorbidities.From the Psychosocial Factors: section, select No or Yes if the if the Veteran will require additional care coordination/support during this episode of care due to any psychosocial factors (e.g. Dementia, Depression, Homelessness, Lack of Caregiver Support).From the Activities of Daily Life, or ADL support: section, select No or Yes if the Veteran will require ADL support.The tool will automatically calculate a level of care coordination based on the answers in is the steps above. The coordination level displays in the New Clinical Triage Coordination Level section.Figure SEQ Figure \* ARABIC 50: New Clinical Triage Coordination LevelBased on clinical judgment, the clinical care coordinator may override the automated result. If manual adjustment is required for the level of care coordination, select the revised level in the drop-down menu along with the reason for adjustment in the text box.In the Reasons for manual adjustment of care coordination level: field, enter a clinical reason for manually changing care coordination level.The Final Clinical Triage Coordination Level: auto-populates based on the completion of clinical triage questions or manual override. In the Name of scheduling staff member: field, enter the name of the staff member.Select the Remember staff person for next referral check box if you want Consult Toolbox to remember the staff person.Click OK. The screening/triage tool will populate a comment in the body of the consult detailing the level of care coordination, directions for proceeding with care coordination, and a list of potential care coordination services required by the Veteran. The comment will also provide guidance on the frequency of contact and need for warm handoff.Figure SEQ Figure \* ARABIC 51: Comment Added to ConsultAuthorizationThis information documented within the Authorization tab populates from data contained in the consult if present, but will not be added to the consult again unless changes and the checkbox is checked shown and described below. Figure SEQ Figure \* ARABIC 52: Authorization TabService Line – A broad category for the services and procedures included which is intended to be used as a way to group and filter SEOCs for easier accessibility. A standardized 3-letter abbreviation of the service line is included at the beginning of the SEOC ID.Figure SEQ Figure \* ARABIC 53: Service Line Menu OptionsSEOC – A SEOC selection is mandatory on every Community Care consult. If a SEOC has not been previously placed to the Consult, users should use Consult Toolbox to write a SEOC to the consult.If SEOC database is unavailable the SEOC Database Unreachable Message displays. Contact the NSD if no SEOCs are available in th drop-down menu.Figure SEQ Figure \* ARABIC 54: List of Active SEOCs Display SEOC – Option that allows you to view the details of the selected SEOC.Figure SEQ Figure \* ARABIC 55: Display SEOCCommunity Care Coordinator — typically referrals need to include the name of the Community Care Coordinator and a contact number. These can be inserted here. You must check the checkbox for this to be included. For questions, contact this number: - Community Care manager contact phone number.Upon completion of this section — send to HSRM for referral. If this check box is selected, a consult will transfer to HSRM in approved status even if the status in CPRS is cancelled, pending, discontinued, etc.Authorization StepsTo view or edit the options within the Authorization tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 56: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 57: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Authorization tab.Figure SEQ Figure \* ARABIC 58: Authorization TabFrom the Service Line drop-down menu, select the best option.From the SEOC drop-down menu, select one of the authorized service listed.Select the Community Care Manager check box to include the name of the Community Care manager and add a contact number. Once the referral is ready for Authorization Form, select the Send to HSRM for Referral check box from the Upon completion of this section:.If the consult has already been sent to HSRM, the following message will display.Figure SEQ Figure \* ARABIC 59: Consult Previously Sent to HSRM Warning MessageSelect the check box if you need to re-send the consult to HSRM for Referral.Click OK.DoDThis information documented within the DoD tab is used for coordinating care between the VA and the DoD Benefits Office.Figure SEQ Figure \* ARABIC 60: DoD TabDoD Urgency – Department of Defense UrgencyUrgency Figure SEQ Figure \* ARABIC 61: DoD Urgency Menu OptionsUrgent – 90 minutesRoutine – 2 business daysDoD facility contacted to request care – Name of DoD facility contacted to request care.DoD StepsTo view or edit the options within the DoD tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 62: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 63: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the DoD tab. The DoD tab displays.Figure SEQ Figure \* ARABIC 64: DoD TabIf there is a DoD urgency, select the Urgency check box and then select the type of urgency from the drop-down menu.If a DoD facility was contacted to request care, select the check box and enter the name of the facility in the field.Click OK.MSA Pt ContactsFigure SEQ Figure \* ARABIC 65: MSA Pt ContactsUnsuccessful attempts to schedule Veteran — this allows recording first, second, and additional calls made to the Veteran to arrange care. Optionally, an annotation like “No Answer” can be added. Enter information regarding the attempt in the field or select an option from the Opt menu: Mail, Left Voice Mail, or Left Message with Family. First call to VeteranSecond call to Veteran Third or additional call to VeteranUnable to Contact letter sent to Veteran — use this selection when a letter is sent to the Veteran indicating that the clinic has been trying to reach him/her to schedule an appointment. This comment may be used each time a letter is sent, if sent more than once.Letter Sent by Certified Mail—this is an additional indication that the letter above was sent by certified mail. Note that the certified mail indicator should be used in conjunction with the unable to contact letter.Additional Results from AttemptAll listed phone numbers disconnected or wrong number—used when all the numbers listed for the Veteran are wrong (disconnected or you reach someone who doesn’t know the Veteran). This should not be used unless you have confirmed that all numbers in the record are bad.Address bad or No address on file, unable to contact by letter—this would apply in the instance where a letter sent has been returned by the post office or in the case of homeless Veterans. The latter case may require extra effort with the Homeless Veterans’ Program to try to reach the Veteran. Veteran ContactedVeteran Informed of eligibility, referral and approval—this simply documents that the Veteran has been informed of Community Care eligibility. Veteran’s Participation PreferenceOpt-In for Community Care—documents Veteran has opted-in. Opt-Out for Community Care—documents Veteran has opted-out for Community Care. Mailing Address Confirmed—indicates that the mailing address on file is correct. If not correct, MSA should correct the address, and then confirm that it is correct. Verified Best Contact Number—documents best number to contact this Veteran. In addition to the actual number, user may also note whether cell, home, or other number. Also, options to confirm existing numbers on file as the best number are provided. Enter the best contact number in the field or select an option from the Opt menu: home number on file, cell number on file, or work number on file.OK to leave appt. details on voice mail—documents that Veteran gives permission to leave appointment details on his/her voice mail.OK to leave appt. details with: —documents that Veteran gives permission to leave details of the appointment with another individual. Anything may be entered, or several options are provided if a specific family member is preferred. Enter the name of individual that the Veteran gives permission to leave details of the appointment with in the field or select an option from the Opt menu: Spouse, Daughter, Son, Caregiver, or Family.Veteran contacted Community Care officeContact NotesProvider Preference:Pref. referral package Method:FaxHSRM PortalMailSecure EmailVeteran’s Preferred Provider Information — if the Veteran has a provider they would like to see, that can be recorded here. Use the lookup tool so the correct provider information (including NPI number) can be part of the record. This pulls data from the Department of Health and Human Services database, which is updated dailyVeteran has a Preferred Provider: Finding the preferred provider can be conducted using the Lookup a Provider option.Update record with above informationVeteran OK to see other than Pref. Provider — if the Veteran has indicated a preferred provider, this documents whether they are willing so see someone else if there is no opportunity to see their preferred provider (provider not available or not willing to take Veteran).YesNoLookup a Provider - Finding the preferred provider can be conducted using the Lookup a Provider option.Figure SEQ Figure \* ARABIC 66: Search by Provider TabProv. Last Name: - This field may be used for NPI searching.Prov. First Name: - This field may be used for NPI searching.Degree:Provider Phone:Provider Specialty: - This field may be used for NPI searching.Provider Street:Provider City: - This field may be used for NPI searching.Provider State: - This field may be used for NPI searching.Provider Zip:NPI (look up): - This field may be used for NPI searching.Suppress Provider Address (recommended)Figure SEQ Figure \* ARABIC 67: Search by Institution TabInstitution Name: - This field may be used for NPI searching.Institution Phone:Institution Street:Institution City: - This field may be used for NPI searching.Institution State: - This field may be used for NPI searching.Institution Zip:NPI (look up): - This field may be used for NPI searching.Suppress Institution Address Veteran’s appt time preference: this is an optional field that allows documentation of time of day preference. It can be Any, Morning, Afternoon, or anything else you’d like to enter.Veteran’s day/date preference: documents day of week or date Veteran would prefer the appointment. This is a free text field, though a CAL button is available to pick a specific date.Veteran prefers to self scheduleVeteran’s Communication Preference Method: documents how the Veteran would like to be notified of appointment when scheduled. Options are: Home PhoneCell PhoneMailMHV Secure MessageTextWilling to travel up to (miles): documents Veteran’s willingness to travel said number of miles to see a provider.Refer to clinical reviewer for disposition after unsuccessful scheduling effort — after failing to schedule an appointment by making two calls, sending a letter, and waiting two weeks, this option refers the consult to a clinician to review and disposition. Business rules for certain low-risk consults may allow the scheduler to discontinue without clinician review, or in the case the provider previously reviewed the consult and determined that it may be discontinued after a failure to schedule after mandated effort, or multiple missed appointments.MSA Pt Contacts StepsTo view or edit the options within the MSA Pt Contacts tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 68: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 69: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the MSA Pt Contacts tab.Figure SEQ Figure \* ARABIC 70: MSA Pt Contacts TabFrom the Unsuccessful Attempts to Schedule Veteran section, select the best option.From the Additional Results from Attempt section, select the best options.From the Veteran Contacted section, select the best options.From the Veteran’s Participation Preference section, select the best options.From the Provider Information section, select the best options.From the Provider Preference section, select the best options.Select the Refer to clinical reviewer for disposition after unsuccessful scheduling effort check box if after failing to schedule an appointment by making two calls, sending a letter, and waiting two weeks, this option refers the consult to a clinician to review and disposition. Click OK.Appt TrackingFigure SEQ Figure \* ARABIC 71: Appt Tracking TabProvider requires records to review prior to scheduling — records a situation where the potential Community Care provider requires records to be reviewed prior to accepting the referral.Document Uploaded to TPA Portal — allows Community Care staff to record when documentation for a Community Care referral has been uploaded to the TPA’s portal. Note, during the document upload process, the unique ID will also be included.Records faxed/sent to Community Care Provider — Follow up call made to provider/vendor to check on status—documents a follow up call to vendor to check on referral status, such as in the case where records review was required.Time sensitive appointment, NLT—documents a no later than date for the appointment to be munity Care apt has been—scheduled or unscheduled. This allows Community Care staff to flag the consult as having an appointment under Community Care.Appointment Date: Records the appointment date. This is not required if a shadow appointment has been scheduled in VistA Scheduling. This is a free text entry field; however, a calendar widget is provided for easy date and time entry. Figure SEQ Figure \* ARABIC 72: Appointment Date Calendar ViewComment – Actual/Approved Provider Information — The name of the actual provider with whom the Veteran has an appointment should be selected using the Lookup a Provider button, which works the exact same as the one on the MSA Pt Contacts tab. It may be different from the one the Veteran preferred if, for instance, the provider was unable to see Veteran, or was not participating as a VA community provider. Update record with above informationAvailable Community Care Facility & Provider LocatorVeteran informed of scheduled appt. by—Enter the method of notification for the scheduled appointment in the field or select an option from the Opt menu: mail, phone, phone and mail, or MyHealtheVet.Referral Authorization Packet Mailed to Veteran—referral authorization packet mailed to VeteranReturned from Community Care Provider: — These data fields are used to indicate when a referral has been returned from Community Care Provider with the corresponding rationale. Referral Issues (select specific issue)DuplicateNon Covered Service — Veteran referred to community provider for services that are not part of benefits package.Missing VA Data/Forms — Missing or incomplete documentation required to appoint.VA requested return of referral — VA contacts contractor and requests return of referral.Unable to review within contract standards — Contractor was not able to review within the contract standard.Non-Disclosure of OHI by Veteran — Veteran acknowledges having OHI and fails to provide.Unable to contact Veteran during Out Bound Call Process — Could not appoint due to no contact from Veteran via call or work Issues (select specific issue)No Network Provider Available — No network provider available for requested service(s). This does not include a Veteran requesting a specific provider.VA Requested Providers Outside of Network — Non‐contracted provider.Veteran Requested Specific Provider — Veteran requested a specific provider for care that is not available on the PC3 network or by Community Care provider agreement.Appointed with Incorrect Provider/Type of Care — Appointed with incorrect provider or incorrect type of care.Already Appointed — Care has been previously scheduled by the Veteran, VA or the Contractor.Veteran Declined (select specific reason)Veteran Declined Distance — Inside Commute Standard — Network provider is in contractors’ network and within the commute standards.Veteran Declined Distance — Outside Commute Standard — Network provider is in contractors’ network but provider is NOT within the commute standards.Veteran Declined Appt Time — Veteran declined time for scheduled appointment.Veteran Declined Does Not Want Care — Veteran declined request for care.Veteran Declined Use of PC3/Community Care — Veteran no longer wants to participate in the program.Appointment Issues (select specific issue)Veteran No-Show — Veteran did not show up for scheduled appointment.Contractor Return – Unable to schedule within contract terms — Care not scheduled within the contractual time and VA is requesting back due to time lapse.VA Request Return – Care Already Scheduled by Contractor — VA requested the authorization after Contractor scheduled care.Unable to contact Veteran Out Bound Call Process — Could not appoint due to no contact from Veteran via call or N Return Reasons (select specific issue)No CCN Provider Available to Schedule Within Timeliness StandardNo CCN Providers Available to Schedule Within Drive Time Standard Veteran Prefers CCN Provider Outside of Drive Time Standard Veteran Willing to Accept CCN Provider Outside of Drive-Time StandardVeteran Willing to Accept CCN Provider Outside of Timeliness Standard Veteran Prefers Non-CCN Provider Veteran Self-SchedulesService Not Provided in CCNVeteran Deceased or Incapacitated — Authorization returned due Veteran deceased or incapacitated.Disposition of returned referral: - document the status of the referralScheduled using Provider Agreement.In-house VA Appointment arranged.Forwarded to in-house service.Resubmitted new referral authorization to vendor.Scheduled using Community Care.Missed Community Care Appointment, care still Active/Pending: - document the reason for the missed appointment.Veteran was No-Show for community care appointmentVeteran Canceled community care appointment (Cancel by Veteran)Community Care Provider canceled appointment (Cancel by clinic)Veteran declined/refused – using alternate source of paymentVeteran declined/refused community careRefer to clinical reviewer for disposition after unsuccessful scheduling effort — after failing to schedule an appointment by making two calls, sending a letter, and waiting two weeks, this option refers the consult to a clinician to review and disposition. Business rules for certain low-risk consults may allow the scheduler to discontinue without clinician review, or in the case the provider previously reviewed the consult and determined that it may be discontinued after a failure to schedule after mandated effort, or multiple missed appointments.Appt Tracking StepsTo view or edit the options within the Appt Tracking tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 73: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 74: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Appt Tracking tab.Figure SEQ Figure \* ARABIC 75: Appt Tracking TabSelect the best option for appointment tracking.From the Actual/Approved Provider Information section, enter the name of the actual provider with whom the Veteran has an appointment. In the Veteran informed of scheduled appt by: field, enter the method used to inform the Veteran of the schedule appointment or select an option from the Opt menu.Select the Referral Authorization Packet Mailed to Veteran if a packet was mailed to the Veteran.From the Returned from Community Care Provider: section, select the reason why the referral was returned from the Community Care Provider with the corresponding rationale.From the Disposition of returned referral drop-down menu, select the status of the referral.From the Missed Community Care Appointment care still Active/Pending drop-down menu, select the reason for the missed appointment.If the records were received, select the Records Received check box and select the option from the drop-down menu.If the Veteran is using an alternate source of payment, select the Veteran declined/refused – using alternate source of payment check box.If the Veteran does not want to use Community Care, select the Veteran declined/refused community care check box.Click OK.Secondary Authorization Request (SAR)/Request for Service (RFS)Figure SEQ Figure \* ARABIC 76: SAR/RFS TabSecondary Authorization Request (SAR)/Request for Service (RFS) sectionSAR/RFS Urgency — Insert the urgency for the secondary authorization request/request for service field or select an option from the Opt menu: Routine, w/in 48 hours, w/in 1 week, or w/in 1 month.SAR/RFS was entered into VistA ImagingYesNoSAR/RFS Details of what was Requested: - comment related to the SAR.Actions Taken Request is Clinically Appropriate – note reasons by check boxes, or with detailed description.Additional Time:Additional ServicesApproved as req. aboveDetailsRequest is not Clinically Appropriate — note reasons by check boxes, or with detailed description. Not a covered benefitMissing DocumentationReassessment by VA Provider RequiredOther reasonNot Clinically AppropriateDenial Details:SAR/RFS StepsTo view or edit the options within the SAR/RFS tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 77: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 78: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the SAR/RFS tab.Figure SEQ Figure \* ARABIC 79: SAR/RFS TabFrom the Secondary Authorization Request (SAR) / Request for Service (RFS) section, enter the SAR/RFS urgency in the field or select an option from the Opt menu.From the SAR/RFS was entered into VistA Imaging drop-down menu, select Yes or No.In the SAR/RFS Details of what was Requested field, enter the details. From the Actions Taken section, select if the SAR/RFS was clinically appropriate or not.Click OK.Consult CompletionFigure SEQ Figure \* ARABIC 80: Consult Completion TabCompletion Efforts(1st) First attempt to get records — documents first request for records for Community Care. (2nd) Second attempt to get records — documents second request for records for Community Care. (3rd) Third attempt to get records — documents third request for records for Community Care.Records Received — documents receipt of records pertinent to this consult. This is particularly useful in the case that those records cannot be uploaded to VistA Imaging immediately.Figure SEQ Figure \* ARABIC 81: Records Received Menu OptionsPaper FaxeFaxVHIESecure EmailUS MailEDI Claim AttachmentHSRMDirect – Directly from Veteran.TPA PortalOtherNo records after 3 attempts. — documents that three attempts have been made to receive records. This makes the consult a candidate for administrative closure. Community Care appointment occurred (waiting for records) – Enter information in the field or select an option from the Opt menu: Per Veteran, awaiting records/confirmation, Per TPA Portal, awaiting records, or Per Provider, awaiting records.Refer to Clinical Care Coordinator — clinical review determines next steps after care when there are no records. Consult Completion StepsTo view or edit the options within the Consult Completion tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 82: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 83: Receive MenuFrom the Receive menu,, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Consult Completion tab.Figure SEQ Figure \* ARABIC 84: Consult Completion TabFrom the Completion Efforts section, select the options for completion.In the Community Care appointment occurred (waiting for records) field, enter the information or select an option from the Opt menu.Click OK.Discontinuing ConsultWhen discontinuing a consult, a reason that meets central office criteria must be entered to document the reason for discontinuation. Right clicking the text area will bring up the list of approved reasons. Additional comments may be made as well. There are two tabs, one relates to in-house consults, and one for Community Care consults. Figure SEQ Figure \* ARABIC 85: General Discontinuation Comments TabDiscontinue consult requires one of the following reasons sectionDuplicate Request Veteran declined/refused-does not want the appointment Care is no longer needed Veteran does not meet eligibility requirements – This is to be used where VA benefits or the Veteran’s clinical situation do not allow them to receive this service from the VA. An example would be routine dental care for a Veteran not eligible for dental care. Veteran has expired – Use if Veteran is deceased.Failed mandated scheduling effort (Missed appointments or no response to attempts to schedule.) – use when Veteran has missed two or more appointments or fails to respond to mandated minimum number of calls, letter(s), and adequate time to respond.Established patient, follow up appointment has been scheduled – this indicates that the established Veteran has been scheduled with a follow up appointment, and the consult is no longer needed.Entered/Requested in error –Other Reason: - Other reason requires details or explanation back to sender. Enter a reason in the field or select an option from the Opt menu. In addition, selection of this option will prompt for an explanation. This option is used primarily when there is some defect in the request, so feedback to the ordering clinician is appropriate.Figure SEQ Figure \* ARABIC 86: Other Reason OptionsIncorrect Service Incomplete Workup Does not meet criteria Recommend alternative to consultFigure SEQ Figure \* ARABIC 87: Comm Care Discontinuation Comments TabDiscontinuation related to Community Care sectionThe care will be provided through a Community Care Consult – Care will be provided by Community Care. USE WITH CAUTION. This is saying that this consult is being discontinued and a Community Care consult will be issued for this service. Typically, a consult should only be discontinued when a Community Care appointment has been scheduled (See next option).This option would be selected when, for example, an Interfacility Consult is sent from Site A to Site B, enabling Community Care. The consult would then be discontinued by staff at Site B with instructions to order a Community Care consult at site A. Not Administratively eligible – Veteran is not eligible. Not Eligible for Community Care – Veteran is not eligible for Community Care.Veteran Community Care appointment scheduled – This is used when the TPA has confirmed that an appointment has been scheduled for the Veteran. Appt Date: - Additionally, the date of the appointment can be recorded. Note that the calendar widget contains a default date, so you must check the box to indicate that the date in the box is the appointment date for it to be recorded. Provider for Community Appt: - If the name of the provider is known, that should be added as well. If the provider name field is filled in, that is also added to the consult comment. Veteran refuses Community Care Appointment – used when the Veteran refuses non-VA appointment. Community Care disapproved – used when the request for non-VA care is disapproved or does not meet requirements. Community Care not needed, care provided by another VA appointment – use when, apart from this consult, the Veteran’s needs were met by care already received at another appointment. Consider using a duplicate request if more appropriate. Discontinuing In-house Consult StepsTo discontinue an in-house consult, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Discontinue. The Discontinue Consult dialog box opens.Figure SEQ Figure \* ARABIC 88: Discontinue Consult Dialog BoxIn the Comments field, right-click to display the Discontinuing Consult menu.Figure SEQ Figure \* ARABIC 89: Discontinuing Consult Menu From the Discontinuing Consult menu, select Discontinuation Reasons. The Discontinue Consult Options window opens.Figure SEQ Figure \* ARABIC 90: Discontinue Consult OptionsSelect the General Discontinuation Comments tab.From the Discontinue consult requires one of the following reasons section, select the reason why the consult is being discontinued. Click OK.Discontinuing Community Care Consult StepsTo discontinue a Community Care consult, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Discontinue. The Discontinue Consult dialog box opens.Figure SEQ Figure \* ARABIC 91: Discontinue Consult Dialog BoxIn the Comments field, right-click to display the Discontinuing Consult menu.Figure SEQ Figure \* ARABIC 92: Discontinuing Consult Menu From the Discontinuing Consult menu, select Discontinuation Reasons. The Discontinue Consult Options window opens.Select the Comm Care Discontinuation Comments tab.Figure SEQ Figure \* ARABIC 93: Comm Care Discontinuation Comments TabFrom the Discontinuation related to Community Care section, select the Community Care discontinuation reason.CAUTION: The care will be provided through a Community Care Consult option should be used with CAUTION. This is saying that this consult is being discontinued and a Community Care consult will be issued for this service. Typically, a consult should only be discontinued when a Community Care appointment has been scheduled (See next option).This The care will be provided through a Community Care Consult option would be selected when an Interfacility Consult is sent from Site A to Site B. The consult would then be discontinued by staff at Site B with instructions to order a Community Care consult at site A.The calendar widget contains a default date, so you must check the box to indicate that the date in the box is the appointment date for it to be recorded. Click OK.Forwarding ConsultAt present forwarding only supports forwarding to Community Care.This tab will be used by staff in internal VA clinics if the Veteran has opted in to receive care in the community.Figure SEQ Figure \* ARABIC 94: Forward to Community Care Options TabForward to Community Care Options sectionHas the consult been review for clinical appropriateness? YesNoVeteran Opt-IN for Community Care (Reason required) Wait Time: VA appointment is greater than wait time standardService Not Available: VA facility does not provide the required serviceDrive Time: Veteran lives more than drive time standardsGrandfatheredHardshipNo Full Service VHA Facility1703 (e) EligibilityBest medical interest of Veteran (per Licensed Independent Provider only)Nature or Simplicity of ServiceFrequency of serviceNeed for an attendantPotential for improved continuity of careDifficulty in travelingForwarding Consult StepsTo forward consult, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Forward. The Forward Consult dialog box opens.Figure SEQ Figure \* ARABIC 95: Forward Consult Dialog BoxIn the Comments field, right-click to display the Forward Consult menu.Figure SEQ Figure \* ARABIC 96: Forward Consult Menu From the Forward Consult menu, select Forward Consult to Community Care. The Forward to Community Care Options window opens.Figure SEQ Figure \* ARABIC 97: Forward to Community Care Options WindowFrom the Forward to Community Care Options section, select if the consult has been reviewed for clinical appropriateness.From the Veteran Opt-IN for Community Care section, select the appropriate Community Care reason.Click OK.Adding Comment to ConsultThere are many activities that can take place that should be documented in the medical record, as this is the official Veteran record, and needs to be tracked. The Consult Toolbox makes this quick and easy. The activities are divided into four user groups, and then from the group, specific activities can be documented. The four groups are:Scheduler FunctionsCommunity Care FunctionsClinical Review OptionsLaunch DSTScheduler FunctionsThe Scheduler Options window documents Consult Management for In-House Schedulers. The In-House Schedulers can document activity in three tabs: Calls and LettersSched/Rescheduling EffortsCommunity Care EligibilityScheduling Calls and LettersIt is important to note that if a call results in a successfully scheduled appointment, these comments are not required. When an appointment is scheduled, it should be linked to the consult which will, in turn, annotate the consult and change the status to “Scheduled.” The comments are intended for documentation of scheduling effort when there has not been an appointment scheduled, so that unsuccessful calls to the Veteran may be documented. In those cases, it should be recorded that the Veteran was called, and the attempt was unsuccessful. This includes the case where the Veteran is contacted, but they didn’t want to schedule the appointment at that time.Figure SEQ Figure \* ARABIC 98: Calls and Letters TabUnsuccessful attempts to schedule Veteran Opt menu, select the best option.No Answer—used when you attempt to call the Veteran but there is no voice mail to leave a message.Left message on voicemail—used when you leave a message on the Veteran’s voice mail to call back. You should not provide any details that might violate PHI restrictions, but your number to return the call would be appropriate.Left message with family member—used when you speak to a family member, but they are unable to commit to an appointment on behalf of the Veteran.Unable to leave message—used when you speak to a family member, but they are not able to take a message. You should not provide any details that might violate PHI restrictions, but your number to return the call would be appropriate.Unsuccessful attempts to schedule VeteranSelect first, second, or third call to Veteran as appropriate. If the Veteran has no-showed or cancelled, then you need to start over with a new scheduling effort and first, second, and possibly third or additional calls. If you make more than three calls, use the 3rd call for all subsequent calls.Unable to Contact letter sent to Veteran—use this selection when a letter is sent to the Veteran indicating that the clinic has been trying to reach the Veteran to schedule an appointment. This comment may be used each time a letter is sent, if sent more than once.Letter Sent by Certified Mail—in the case of high risk consults, business rules for the clinic or upon suggestion of the provider, it may be appropriate to send the Veteran a certified letter indicating that they have a potentially serious condition, and that the VA has been unsuccessful reaching them to provide care. Additional results from scheduling attemptSpoke with veteran/care giver—this documents that you did in fact talk to the Veteran or their care giver.Veteran declined/refused – going to private provider outside VA Care – the Veteran has indicated that they would rather use their private insurance and arrange care outside the VA at his/her own expense.Veteran declined/refused – does not want care – this selection is used if the Veteran tells the scheduler they do not want to schedule the appointment. Depending on the business rules for the clinic, they may very well require review by a licensed practitioner before discontinuation.Veteran wants to call back to schedule—this is when you do speak to the Veteran/care giver, but they don’t want to make the appointment at that time, but indicate they’ll call back to schedule. This is an example of a case where the Veteran was reached, but this would count as an unsuccessful attempt to schedule.Phone numbers disconnected or wrong number—used when all the numbers listed for the Veteran are wrong (disconnected or you reach someone who doesn’t know the Veteran). This should not be used unless you’ve confirmed that all numbers in the record are bad.No address on file, unable to send letter—this would apply in the instance where a letter sent is returned by the post office, or in the case of homeless Veterans. The latter case may require extra effort with the Homeless Veterans Program to try to reach the Veteran. Scheduling Calls and Letters StepsTo schedule calls and letters, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 99: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 100: Community Care Menu From the Community Care menu, select Scheduler Functions. The Scheduler Options window opens with the Calls and Letters tab displayed.Figure SEQ Figure \* ARABIC 101: Calls and Letters TabIn the Unsuccessful attempts to schedule Veteran field enter the information or select the best option from the Opt menu.From the Unsuccessful attempts to schedule Veteran section, select if a first, second, or subsequent call to Veteran check box. Select the Unable to Contact Letter sent to Veteran check box if you were unable to reach the Veteran and sent a letter.Select the Letter Sent by Certified Mail check box if you sent a certified letter.From the Additional results from scheduling attempt, select the options you may wish to record to better document efforts. Not all clinics will have a need for all options.If a scheduling effort fails after attempting to schedule an appointment by making two calls, sending a letter, and waiting two weeks, select the Refer to clinical reviewer for disposition after unsuccessful scheduling effort check box.Business rules for certain low-risk consults may allow the scheduler to discontinue without clinician review, or in the case the provider previously reviewed the consult and determined that it may be discontinued after a failure to schedule after mandated effort or multiple missed appointments.Click View Consult History. The Viewing Consult History dialog box displays.Figure SEQ Figure \* ARABIC 102: Viewing Consult HistoryClick Close Consult History.Click OK.Scheduling and Rescheduling EffortsWithin this tab, these data fields track the number of missed appointments and/or the reason Veteran did not want appointment to be scheduled. It is important for in-house Schedulers to document these data fields to eliminate wait lists and decrease wait times for Veterans in need of care. Additionally, by documenting Veteran’s usage of private insurance and preference to seek care outside of the VA at their own expense, VA staff can track the utilization of VA benefits. IMPORTANT: appointments scheduled in VistA Scheduling and properly linked to an appointment will automatically update the consult, with both scheduling appointments and also when appointments are cancelled or the Veteran no-shows. In those cases, there is no need to document missed appointments with the Toolbox. First cancel-by-Veteran or no-show counts as a first missed appointment. Subsequent cancel-by Veteran or no-show counts as the second (or third+) missed appointment. Figure SEQ Figure \* ARABIC 103: Sched/Rescheduling Efforts TabMissed appointmentsFirst Missed appointment (No Show) — missed appointment. It is important to track the missed appointment, as a Veteran who fails to keep appointments may be depriving other Veterans an opportunity to receive care. First Missed appointment (Cancelled by patient)—this is cancelled-by-Veteran. It is important to track this missed appointment, as a Veteran who fails to keep appointments may be depriving other Veterans an opportunity to receive care. Second missed appointmentSecond Missed appointment (No Show)—missed appointment. This should be recorded, and in addition, if the appointment has been pre-reviewed for discontinuation after two missed appointments, the consult should be discontinued in an additional step. If not pre-reviewed, then it should be referred to the provider for disposition.Second Missed appointment (Cancelled by patient)—missed appointment. This should be recorded, and in addition, if the appointment has been pre-reviewed for discontinuation after two missed appointments, the consult should be discontinued in an additional step. If not pre-reviewed, then it should be referred to the provider for disposition. Third or more missed appointment (Cancelled by patient or no-show)—appointments that are missed either by cancel by Veteran or no-show are tracked here, without distinction. Refer to clinical reviewer for disposition after unsuccessful scheduling effortScheduling and Rescheduling Efforts StepsTo schedule and rescheduling efforts, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 104: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 105: Community Care Menu From the Community Care menu, select Scheduler Functions. The Scheduler Options window opens with the Calls and Letters tab displayed.Figure SEQ Figure \* ARABIC 106: Calls and Letters TabSelect the Sched/Rescheduling Efforts tab.Figure SEQ Figure \* ARABIC 107: Sched/Rescheduling Efforts TabFrom the Missed appointments (properly linked appointments in VistA will document no shows and cancellations) section, select the best option.From the Second missed appointment (If Veteran previously no-showed or cancelled) section, select the best option.If a scheduling effort fails after attempting to schedule an appointment by making two calls, sending a letter, and waiting two weeks, select the Refer to clinical reviewer for disposition after unsuccessful scheduling effort checkbox.Business rules for certain low-risk consults may allow the scheduler to discontinue without clinician review, or in the case the provider previously reviewed the consult and determined that it may be discontinued after a failure to schedule after mandated effort or multiple missed appointments.Click munity Care EligibilityThis data field documents a Veteran’s decision to opt-in or out of the Veterans Community Care Program (VCCP) if there is insufficient access within a VA clinic. Figure SEQ Figure \* ARABIC 108: Community Care Eligibility TabVeteran’s Participation Preference sectionOpt-IN for Community Care (Reason required)—this documents that the Veteran opts in for Community Care.Opt-OUT for Community Care—this documents that the Veteran opts out for Community Care.Scheduling to be performed byVA schedules based on Veteran’s preferencesVeteran self-schedulesCommunity provider schedules directly with VeteransVeteran’s Provider and Appointment Preferences sectionVeteran has a Preferred Provider - Finding the preferred provider can be conducted using the Lookup a Provider option.YesNoUpdate record with above informationVeteran OK to see other than Pref. Provider - if the Veteran has indicated a preferred provider, this documents whether they are willing so see someone else if there is no opportunity to see their preferred provider (provider not available or not willing to take Veteran).Yes NoLookup a Provider - Finding the preferred provider can be conducted using the Lookup a Provider option.Figure SEQ Figure \* ARABIC 109: Search by Provider TabProv. Last Name: - This field may be used for NPI searching.Prov. First Name: - This field may be used for NPI searching.Degree:Provider Phone:Provider Specialty: - This field may be used for NPI searching.Provider Street:Provider City: - This field may be used for NPI searching.Provider State: - This field may be used for NPI searching.Provider Zip:NPI (look up): - This field may be used for NPI searching.Suppress Provider Address (recommended)Figure SEQ Figure \* ARABIC 110: Search by Institution TabInstitution Name: - This field may be used for NPI searching.Institution Phone:Institution Street:Institution City: - This field may be used for NPI searching.Institution State: - This field may be used for NPI searching.Institution Zip:NPI (look up): - This field may be used for NPI searching.Suppress Institution Address Facility & Service Locator- Finding the preferred facility and service can be conducted using the Facility & Service Locator option. This option will take you to the VA Community Provider Locator.Veteran’s appt time preference:Any MorningAfternoonVeteran’s day/date preference:Veteran’s Communication Preference Method:Home PhoneCell PhoneMailMHV Secure MessageTextWilling to travel up to (miles):Community Care Eligibility StepsTo set the Community Care eligibility, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 111: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 112: Community Care Menu From the Community Care menu, select Scheduler Functions. The Scheduler Options window opens with the Calls and Letters tab displayed.Figure SEQ Figure \* ARABIC 113: Calls and Letters TabSelect the Community Care Eligibility tab.Figure SEQ Figure \* ARABIC 114: Community Care Eligibility TabFrom the Veteran’s Participation Preference section, select if the Veteran is opting in or opting out of Community Care.From the Scheduling to be performed by: drop-down menu, select an option.From the Veteran’s Provider and Appointment Preferences section, select the options to document the Veteran’s preferences.Click OK.Unable to Schedule FunctionsThe Unable to Schedule function is the replacement for Veterans awaiting care via the EWL in VistA. The use of the Unable to Schedule function should not be used for administrative transfer requests. The use of the Light Electronic Action Framework (LEAF) should be used for administrative transfer requests. Staff who receive and schedule internal VA consults are required to activate and utilize the Consult Toolbox when available to document reasons that consults cannot be scheduled and to monitor these requests for care. Unable to Schedule consults should remain in an Active status until the patient is scheduled or care is delivered.Providers and schedulers will only use this option when receiving an internal VA consult that cannot be scheduled 390 days in the future and the Veteran has already declined Community Care or there is no comparable service in the community. Right clicking the text area while receiving a consult or when adding a comment will bring up the list of approved reasons. Selecting one or more of these reasons will provide standard text that may be inserted in the consult comments to document why the consult cannot be appropriately scheduled.Figure SEQ Figure \* ARABIC 115: Receive Unable to Schedule WindowPrefers VA/No Capacity – Wants VA care (opts out of Community Care) and is waiting for availability. Care need is not met.No Comparable Service in the Community – Service is unique to VA this is specific to GEC, Home Base Primary Care (HBPC), and Mental Health services, where the care is not offered in the community (e.g., Spinal Cord Injury, Purchased GEC Care, HBPC with no VA Primary Care).Receiving Care/Awaiting Specialized Service – Care needs being met in VA while waiting for specialized VA service (e.g., HBPC Patients receiving VA Primary Care).Unable to Schedule StepsTo receive consult, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 116: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 117: Community Care Menu From the Community Care menu, select Unable to Schedule. The Unable to Schedule window opens.Figure SEQ Figure \* ARABIC 118: Unable to Schedule WindowFrom the Unable to Schedule section, select one or more reasons you were unable to schedule the consult.Click OK.If you click OK before selecting an option, you will receive an error message stating that you must make a selection to munity Care FunctionsFor instructions on how to assign priority during the COVID-19 Pandemic please refer to REF _Ref39063802 \h \* MERGEFORMAT Appendix A1.3: Receive Community Care Functions: COVID-19 Priority and REF _Ref39063803 \h \* MERGEFORMAT Appendix A2.3: Add Comment Community Care Functions: COVID-19 munity Care functions document activities that have taken place within the Community Care programs that are provided by the VA. When compiling pertinent medical documentation for upload to the TPA Portal, it is highly recommended that the Referral Documentation Tool (REFDOC) be used. REFDOC is an innovative solution that extracts from the Veteran’s electronic medical record and records into PDF format for exchange with community care providers. REFDOC improves the timeliness of medical record transfers by allowing VA staff to quickly extract Veterans’ health information from Veterans Health Information Systems and Technology Architecture (VistA), Computerized Patient Record System (CPRS), and Corporate Data Warehouse (CDW) and compile it into a PDF package that can be easily shared with community providers.MSA Eligibility VerificationFigure SEQ Figure \* ARABIC 119: MSA Elig. Verification TabSpecific Eligibility Verified—allows staff to further signify that the Veteran is eligible under one of the administrative eligibilities. This option allows the user to identify Community Care eligibility. The drop-down offers the following options:Figure SEQ Figure \* ARABIC 120: Specific Eligibility Verified Menu OptionsBMI-HardshipBMI-per episode of careDrive TimeGrandfathered under ChoiceNo Full Service VA Available in State1703 (e) EligibilityService Not AvailableWait Time – VA appointment is not available within the wait time standard.*Grandfathered eligibility from Veterans Choice Program.Presumed eligible, HEC Update Pending —This is typically appropriate when a new Veteran is being registered and all evidence indicates (e.g. a DD 214 form) that the person is indeed a Veteran, but the eligibility cannot be verified by the Health Eligibility Center’s (HEC) systems. This is an indication that the record requires action by the HEC before the consult can move forward. Unable to Verify Eligibility —Staff member should take steps to verify eligibility. Staff is unable to verify the person’s eligibility for VA care or Community Care. This allows documentation of that fact and alerts the staff to refer the case to the appropriate person for resolution. A comment is available for further clarification but is not mandatory.Delegation of Authority Medical Services List Reviewed section. — This allows staff to select if clinical review is required, by checking a box.Clinical review requiredDoes not require clinical reviewDocument Administrative ScreeningCommunity Care MSA Eligibility Verification StepsTo set the Community Care MSA Eligibility Verification options, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 121: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 122: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Figure SEQ Figure \* ARABIC 123: MSA Elig. Verification TabSelect the Specific Eligibility Verified, Presumed eligible, HEC Update Pending, or Unable to Verify Eligibility check box that best describes the Community Care MSA eligibility verification.CAUTION: Staff must contact local enrollment and eligibility office before proceeding.Once you have contacted local enrollment and eligibility, select the best option from the Delegation of Authority Medical Services List Reviewed section. Information under Document Administrative Screening is populated and provides care coordination information about this Veteran. Additional details are in Community Care Document Administrative Screening and Clinical Triage tool section.Click munity Care (CC) Document Administrative ScreeningThe Screening/Triage tool enables staff to assess the Veteran’s care coordination needs in the community. The tool consists of an administrative screening and clinical triage sections. While the administrative section may be completed by any integrated team staff member (MSA/PSA, Social Worker, RN), the clinical section may be only completed by clinical staff. The administrative section consists of questions about the urgency of the Veteran’s care request, the requested services in the consult, and the corresponding Veteran CAN (Care Assessment Need) score, accessible through VSSC. Based on the answers in this section, the tool will determine whether a clinical assessment will be necessary. If so, the tool will prompt the user to input the name of the RN responsible for completing the clinical section and send an alert. Figure SEQ Figure \* ARABIC 124: Administrative ScreeningAdministrative Screening for Care Coordination and Case Management section:Are you a clinical staff member: Yes or No—the first question asks if you are a clinical staff member. This box will screen to see if clinical staff needs to review an alert, which wouldn’t be needed if the user is a clinical staff person.Urgency: is appointment needed within 48 hours—if urgent care coordination is required, this should be forwarded immediately for clinical triage. (If within 48 hours, skip remaining questions and forward for clinical triage.)Does the consult specify any of the following complex conditions or services? — if the consult specifies any complex conditions or services, select one of the following options from the drop-down menu.New Cancer DiagnosisOutpatient SurgeryCoronary Artery Bypass (CABG)Chronic Heart FailureChronic Obstructive Pulmonary Disease/PneumoniaInpatient Hospitalization (any cause)None of the aboveDoes the consult specify any of the following basic services — if the consult specifies basic services, select the applicable service from the drop-down menu.Routine therapeutic services (Dialysis, OT, PT, RT)Routine MammographyCervical Ca Screening (PAP Test)Complimentary and integrated medicineDirect SchedulingRoutine Screening ColonoscopyLow Dose CT ScansNone of the aboveCAN Score — CAN Scores serve as an important component to the Screening/Triage process providing a standardized evidence-based measure of Veteran risk. CAN Scores measure the probability of inpatient admission or death within a specified period of time (1 year) in percentage form. Toolbox automatically retrieves the CAN Score for a patient from the CDW via the CAN Score service.If the CAN Score service is unavailable or a CAN Score does not exist for a patient, manual entry of the CAN Score is enabled. Figure SEQ Figure \* ARABIC 125: CAN Score Fields EnabledTo access a Veteran’s CAN Score manually, the staff will be required to access VHA Support Service Center (VSSC). If CAN (Care Assessment Needs) Score is known, make the appropriate selection, or if not available, select No CAN Score Available from the following choices: 0 to 7475 to 90Over 90No CAN Score AvailableCAN Score for: - Name of Veteran.DOB: - Veteran’s date of birth.SSN: - Veteran’s social security number.CAN Score: - Veteran’s CAN Score.Current Coord Level Assessment: - If this is not Basic, a box will open to input the name of the clinical staff member responsible for completing the clinical triage portion of the tool. This is not shown for clinical staff. This does not send the actual alert, the user is responsible for sending the alert using the Send additional alerts button on the comment screen:Clinical Triage: - If the level of care coordination determined in the administrative screening section is not basic, the administrative staff member will alert a clinical care coordinator to complete the clinical triage section below. The clinical section consists of questions regarding the Veteran’s comorbidities, social factors, and need for assistance with Activities of Daily Living (ADLs). There is also a drop-down menu which the clinical care coordinator may fill out to override the results of the tool using clinical evidence-based judgment.If clinical triage has already been performed, it will show. Also, if care coordination has already been assigned by Administrative screening (as in the example below) that will also show.Scheduling staff member you will alert: - Name of the scheduling staff member.Remember staff person for next referral: - option that tells the Consult Toolbox to remember the selected scheduling staff person for the next munity Care (CC) Document Administrative Screening StepsFigure SEQ Figure \* ARABIC 126: MSA Elig. Verification Tab: Document Administrative Screening SectionFrom the MSA Elig. Verification tab, click Document Administrative Screening. The Administrative Screening (for use by community care staff only) window opens. Figure SEQ Figure \* ARABIC 127: Administrative Screening (for use by community care staff only) WindowIf clinical review has already been performed, it will show. If administrative screening has been performed on this consult previously, it will be indicated as such in the administrative screening section.Select the Yes or No radio button for the From the Are you a clinical staff member question.Select the Yes or No radio button if there is an urgency to have an appointment in the next 48 hours.From the Does the consult specify any of the following complex conditions or services? drop-down menu, select if the consult specifies any complex conditions or services.Either a complex or basic service may be selected from the drop-down menus but not both, if both are selected the first selection will be reset to “None of the above”.From the Does the consult specify any of the following basic services? drop-down menu, select the applicable service.From the CAN Score section, select appropriate selection with regards to the CAN Score. If the Current Coord Level Assessment is not Basic, input the name of the clinical staff member responsible for completing the clinical triage portion of the tool in the Name of scheduling staff member you will alert: field. This is not shown for clinical staff. Figure SEQ Figure \* ARABIC 128: Scheduling staff member you will alert: FieldSelect the Remember staff person for next referral check box if you would like Consult Toolbox to remember your selection for the next referral.This does not send the actual alert, the user is responsible for sending the alert using the Send additional alerts button on the comment screen:Click OK. The Document Administrative Screening information will populate on the MSA Elig. Verification tab.Figure SEQ Figure \* ARABIC 129: Document Administrative Screening PopulatedConsult ReviewFigure SEQ Figure \* ARABIC 130: Consult Review TabCommunity Care Clinical Review (for use by community care staff only)Request Approved (Select CC Program)— Optional field. Various Community Care programs can be selected but must be one of the listed in the drop-down menu.Figure SEQ Figure \* ARABIC 131: Request Approved OptionsIf you are located in Alaska , Tribal will be an additional option in the Request Approved (Select CC Program) drop-down menu.The Request Approved (Select CC Program) list is intended to display the approved program authorities used to purchase care in the ment:Request disapproved (reason) —reason request disapproved, enter other reason in the field or select an option from the Opt menu.Figure SEQ Figure \* ARABIC 132: Request Disapproved OptionsNot Medically NecessaryDuplicate ConsultService available at the VAOther VA Providing CareIncomplete Information Not a Covered ServiceClinical Review Method: Figure SEQ Figure \* ARABIC 133: Clinical Review Method Menu OptionsMCG GuidelinesInterQual CriteriaChief of Staff approved ProtocolHardship Request Approval: Is this a Community Care-Hardship Determination consult?Request Approved by COS or by his or her designeeApproved for 6 monthsApproved for 12 monthsRequest Disapproved by COS or by his or her designee Provider may authorize discontinuation after failure of mandated scheduling effort without further clinical reviewMay discontinue if Veteran cancels/no-shows or fails to respond to mandated scheduling effort — If the Provider authorizes discontinuation after failure of mandated scheduling effort without further clinical review.twiceonceIs responsible for schedulingVA Staff VA schedules based on Veteran’s preferenceVeteran self-schedulesCommunity provider schedules directly with VeteranCommunity Care ContractorDocument Clinical TriageConsult Review StepsTo set the CC Consult Review options, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 134: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 135: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Consult Review tab.Figure SEQ Figure \* ARABIC 136: Consult Review TabFrom the Community Care Clinical Review section, select if the request was approved or disapproved. If the request was approved, you will need to select the CC Program from the drop-down. If the request was not approved, you will need to select the reason from the Opt menu.From the Hardship Request Approval section, select the best options.If the Provider authorizes discontinuation after failure of mandated scheduling effort without further clinical review, select May discontinue if Veteran cancels/no-shows or fails to respond to mandated scheduling effort check box and select the number of times from the drop-down menu.From the Is responsible for scheduling section, select if the scheduling will be done by either VA Staff or Community Care Contractor.Click OK.Clinical TriageIf the level of care coordination determined in the administrative screening section is not basic, the administrative staff member will alert a clinical care coordinator to complete the clinical triage section below. The clinical section consists of questions regarding the Veteran’s comorbidities, social factors, and need for assistance with Activities of Daily Living (ADLs). There is also a drop-down menu which the clinical care coordinator may fill out to override the results of the tool using clinical evidence-based judgment.If clinical triage has already been performed, it will show. Also, if care coordination has already been assigned by Administrative screening that will also show.Figure SEQ Figure \* ARABIC 137: Clinical Triage for Care CoordinationClinical Care Coordination AssignmentThe Screening/Triage tool will recommend a care coordination level once the following items are populated:Veteran Comorbidities:—select yes or no if based on your review of Veteran information and clinical judgement if the Veteran will require additional care coordination/support during this episode of care due to two or more comorbidities.Psychosocial Factors:—select yes or no if based on your review of the Veteran information and clinical judgement, if the Veteran will require additional care coordination/support during this episode of care due to any psychosocial factors (e.g. Dementia, Depression, Homelessness, Lack of Caregiver Support).Activities of Daily Life, or ADL support: –select yes or no if based on your review of Veteran information and clinical judgement, if the Veteran will require ADL support.New Calculated Assessment: — the tool will calculate a level of care coordination based on the answers in the administrative screening and clinical triage sections as displayed below:Based on review of Veteran information and clinical judgement, the level of care coordination should be manually adjusted to: - Based on clinical judgment, the clinical care coordinator may override the automated result. If manual adjustment is required for the level of care coordination, select the revised level in the drop-down menu along with the reason for adjustment in the textbox below.BasicModerate ComplexUrgentReasons for manual adjustment of care coordination level — enter a clinical reason for manually changing care coordination level.Final Clinical Triage Coordination Level: - auto-populates based on the completion of clinical triage questions or manual override. Name of scheduling staff member: - Name of the scheduling staff member.Remember staff person for next referral – option that tells the Consult Toolbox to remember the selected staff person for the next referral.Clinical Triage StepsTo complete the clinical triage, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 138: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 139: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the CC Consult Review tab.Figure SEQ Figure \* ARABIC 140: Consult Review TabClick the Document Clinical Triage button. The Clinical Triage for Care Coordination window opens.Figure SEQ Figure \* ARABIC 141: Clinical Triage for Care CoordinationThe Clinical Triage tool will recommend a care coordination level once the following items are populated.From the Veteran Comorbidities: section, select No or Yes if the Veteran will require additional care coordination/support during this episode of care due to two or more comorbidities.From the Psychosocial Factors: section, select No or Yes if the if the Veteran will require additional care coordination/support during this episode of care due to any psychosocial factors (e.g. Dementia, Depression, Homelessness, Lack of Caregiver Support).From the Activities of Daily Life, or ADL support: section, select No or Yes if the Veteran will require ADL support.The tool will automatically calculate a level of care coordination based on the answers in is the steps above. The coordination level displays in the New Clinical Triage Coordination Level section.Figure SEQ Figure \* ARABIC 142: New Clinical Triage Coordination LevelBased on clinical judgment, the clinical care coordinator may override the automated result. If manual adjustment is required for the level of care coordination, select the revised level in the drop-down menu along with the reason for adjustment in the text box.In the Reasons for manual adjustment of care coordination level: field, enter a clinical reason for manually changing care coordination level.The Final Clinical Triage Coordination Level: auto-populates based on the completion of clinical triage questions or manual override. In the Name of scheduling staff member: field, enter the name of the staff member.Select the Remember staff person for next referral check box if you want Consult Toolbox to remember the staff person.Click OK. The screening/triage tool will populate a comment in the body of the consult detailing the level of care coordination, directions for proceeding with care coordination, and a list of potential care coordination services required by the Veteran. The comment will also provide guidance on the frequency of contact and need for warm handoff.Figure SEQ Figure \* ARABIC 143: Comment Added to ConsultAuthorizationThis information documented within the Authorization tab populates from data contained in the consult if present, but will not be added to the consult again unless changes and the checkbox is checked shown and described below. Figure SEQ Figure \* ARABIC 144: Authorization TabService Line – A broad category for the services and procedures included which is intended to be used as a way to group and filter SEOCs for easier accessibility. A standardized 3-letter abbreviation of the service line is included at the beginning of the SEOC ID.Figure SEQ Figure \* ARABIC 145: Service Line Menu OptionsSEOC – A SEOC selection is mandatory on every Community Care consult. If a SEOC has not been previously placed to the Consult, users should use Consult Toolbox to write a SEOC to the consult.If SEOC database is unavailable the SEOC Database Unreachable Message displays. Contact the NSD if no SEOCs are available in th drop-down menu.Figure SEQ Figure \* ARABIC 146: List of Active SEOCs Display SEOC – Option that allows you to view the details of the selected SEOC.Figure SEQ Figure \* ARABIC 147: Display SEOCCommunity Care Coordinator — typically referrals need to include the name of the Community Care Coordinator and a contact number. These can be inserted here. You must check the checkbox for this to be included. For questions, contact this number: - Community Care manager contact phone number.Upon completion of this section — send to HSRM for referral. If this check box is selected, a consult will transfer to HSRM in approved status even if the status in CPRS is cancelled, pending, discontinued, etc.Authorization StepsTo view or edit the options within the Authorization tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 148: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 149: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Authorization tab.Figure SEQ Figure \* ARABIC 150: Authorization TabFrom the Service Line drop-down menu, select the best option.From the SEOC drop-down menu, select one of the authorized service listed.Select the Community Care Manager check box to include the name of the Community Care manager and add a contact number. Once the referral is ready for Authorization Form, select the Send to HSRM for Referral check box from the Upon completion of this section:.If the consult has already been sent to HSRM, the following message will display.Figure SEQ Figure \* ARABIC 151: Consult Previously Sent to HSRM Warning MessageSelect the check box if you need to re-send the consult to HSRM for Referral.Click OK.DoDThis information documented within the DoD tab is used for coordinating care between the VA and the DoD Benefits Office.Figure SEQ Figure \* ARABIC 152: DoD TabDoD Urgency – Department of Defense UrgencyUrgency Figure SEQ Figure \* ARABIC 153: DoD Urgency Menu OptionsUrgent – 90 minutesRoutine – 2 business daysDoD facility contacted to request care – Name of DoD facility contacted to request care.DoD StepsTo view or edit the options within the DoD tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 154: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 155: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the DoD tab. The DoD tab displays.Figure SEQ Figure \* ARABIC 156: DoD TabIf there is a DoD urgency, select the Urgency check box and then select the type of urgency from the drop-down menu.If a DoD facility was contacted to request care, select the check box and enter the name of the facility in the field.Click OK.MSA Pt ContactsFigure SEQ Figure \* ARABIC 157: MSA Pt ContactsUnsuccessful attempts to schedule Veteran — this allows recording first, second, and additional calls made to the Veteran to arrange care. Optionally, an annotation like “No Answer” can be added. Enter information regarding the attempt in the field or select an option from the Opt menu: Mail, Left Voice Mail, or Left Message with Family. First call to VeteranSecond call to Veteran Third or additional call to VeteranUnable to Contact letter sent to Veteran — use this selection when a letter is sent to the Veteran indicating that the clinic has been trying to reach him/her to schedule an appointment. This comment may be used each time a letter is sent, if sent more than once.Letter Sent by Certified Mail—this is an additional indication that the letter above was sent by certified mail. Note that the certified mail indicator should be used in conjunction with the unable to contact letter.Additional Results from AttemptAll listed phone numbers disconnected or wrong number—used when all the numbers listed for the Veteran are wrong (disconnected or you reach someone who doesn’t know the Veteran). This should not be used unless you have confirmed that all numbers in the record are bad.Address bad or No address on file, unable to contact by letter—this would apply in the instance where a letter sent has been returned by the post office or in the case of homeless Veterans. The latter case may require extra effort with the Homeless Veterans’ Program to try to reach the Veteran. Veteran ContactedVeteran Informed of eligibility, referral and approval—this simply documents that the Veteran has been informed of Community Care eligibility. Veteran’s Participation PreferenceOpt-In for Community Care—documents Veteran has opted-in. Opt-Out for Community Care—documents Veteran has opted-out for Community Care. Mailing Address Confirmed—indicates that the mailing address on file is correct. If not correct, MSA should correct the address, and then confirm that it is correct. Verified Best Contact Number—documents best number to contact this Veteran. In addition to the actual number, user may also note whether cell, home, or other number. Also, options to confirm existing numbers on file as the best number are provided. Enter the best contact number in the field or select an option from the Opt menu: home number on file, cell number on file, or work number on file.OK to leave appt. details on voice mail—documents that Veteran gives permission to leave appointment details on his/her voice mail.OK to leave appt. details with: —documents that Veteran gives permission to leave details of the appointment with another individual. Anything may be entered, or several options are provided if a specific family member is preferred. Enter the name of individual that the Veteran gives permission to leave details of the appointment with in the field or select an option from the Opt menu: Spouse, Daughter, Son, Caregiver, or Family.Veteran contacted Community Care officeContact NotesProvider Preference:Pref. referral package Method:FaxHSRM PortalMailSecure EmailVeteran’s Preferred Provider Information — if the Veteran has a provider they would like to see, that can be recorded here. Use the lookup tool so the correct provider information (including NPI number) can be part of the record. This pulls data from the Department of Health and Human Services database, which is updated dailyVeteran has a Preferred Provider: Finding the preferred provider can be conducted using the Lookup a Provider option.Update record with above informationVeteran OK to see other than Pref. Provider — if the Veteran has indicated a preferred provider, this documents whether they are willing so see someone else if there is no opportunity to see their preferred provider (provider not available or not willing to take Veteran).YesNoLookup a Provider - Finding the preferred provider can be conducted using the Lookup a Provider option.Figure SEQ Figure \* ARABIC 158: Search by Provider TabProv. Last Name: - This field may be used for NPI searching.Prov. First Name: - This field may be used for NPI searching.Degree:Provider Phone:Provider Specialty: - This field may be used for NPI searching.Provider Street:Provider City: - This field may be used for NPI searching.Provider State: - This field may be used for NPI searching.Provider Zip:NPI (look up): - This field may be used for NPI searching.Suppress Provider Address (recommended)Figure SEQ Figure \* ARABIC 159: Search by Institution TabInstitution Name: - This field may be used for NPI searching.Institution Phone:Institution Street:Institution City: - This field may be used for NPI searching.Institution State: - This field may be used for NPI searching.Institution Zip:NPI (look up): - This field may be used for NPI searching.Suppress Institution Address Veteran’s appt time preference: this is an optional field that allows documentation of time of day preference. It can be Any, Morning, Afternoon, or anything else you’d like to enter.Veteran’s day/date preference: documents day of week or date Veteran would prefer the appointment. This is a free text field, though a CAL button is available to pick a specific date.Veteran prefers to self scheduleVeteran’s Communication Preference Method: documents how the Veteran would like to be notified of appointment when scheduled. Options are: Home PhoneCell PhoneMailMHV Secure MessageTextWilling to travel up to (miles): documents Veteran’s willingness to travel said number of miles to see a provider.Refer to clinical reviewer for disposition after unsuccessful scheduling effort — after failing to schedule an appointment by making two calls, sending a letter, and waiting two weeks, this option refers the consult to a clinician to review and disposition. Business rules for certain low-risk consults may allow the scheduler to discontinue without clinician review, or in the case the provider previously reviewed the consult and determined that it may be discontinued after a failure to schedule after mandated effort, or multiple missed appointments.MSA Pt Contacts StepsTo view or edit the options within the MSA Pt Contacts tab, follow the steps below:From the Action menu, select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 160: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 161: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the MSA Pt Contacts tab.Figure SEQ Figure \* ARABIC 162: MSA Pt Contacts TabFrom the Unsuccessful Attempts to Schedule Veteran section, select the best option.From the Additional Results from Attempt section, select the best options.From the Veteran Contacted section, select the best options.From the Veteran’s Participation Preference section, select the best options.From the Provider Information section, select the best options.From the Provider Preference section, select the best options.Select the Refer to clinical reviewer for disposition after unsuccessful scheduling effort check box if after failing to schedule an appointment by making two calls, sending a letter, and waiting two weeks, this option refers the consult to a clinician to review and disposition. Click OK.Appt TrackingFigure SEQ Figure \* ARABIC 163: Appt Tracking TabProvider requires records to review prior to scheduling — records a situation where the potential Community Care provider requires records to be reviewed prior to accepting the referral.Document Uploaded to TPA Portal — allows Community Care staff to record when documentation for a Community Care referral has been uploaded to the TPA’s portal. Note, during the document upload process, the unique ID will also be included.Records faxed/sent to Community Care Provider — Follow up call made to provider/vendor to check on status—documents a follow up call to vendor to check on referral status, such as in the case where records review was required.Time sensitive appointment, NLT—documents a no later than date for the appointment to be munity Care apt has been—scheduled or unscheduled. This allows Community Care staff to flag the consult as having an appointment under Community Care.Appointment Date: Records the appointment date. This is not required if a shadow appointment has been scheduled in VistA Scheduling. This is a free text entry field; however, a calendar widget is provided for easy date and time entry. Figure SEQ Figure \* ARABIC 164: Appointment Date Calendar ViewComment – Actual/Approved Provider Information — The name of the actual provider with whom the Veteran has an appointment should be selected using the Lookup a Provider button, which works the exact same as the one on the MSA Pt Contacts tab. It may be different from the one the Veteran preferred if, for instance, the provider was unable to see Veteran, or was not participating as a VA community provider. Update record with above informationAvailable Community Care Facility & Provider LocatorVeteran informed of scheduled appt. by—Enter the method of notification for the scheduled appointment in the field or select an option from the Opt menu: mail, phone, phone and mail, or MyHealtheVet.Referral Authorization Packet Mailed to Veteran—referral authorization packet mailed to VeteranReturned from Community Care Provider: — These data fields are used to indicate when a referral has been returned from Community Care Provider with the corresponding rationale. Referral Issues (select specific issue)DuplicateNon Covered Service — Veteran referred to community provider for services that are not part of benefits package.Missing VA Data/Forms — Missing or incomplete documentation required to appoint.VA requested return of referral — VA contacts contractor and requests return of referral.Unable to review within contract standards — Contractor was not able to review within the contract standard.Non-Disclosure of OHI by Veteran — Veteran acknowledges having OHI and fails to provide.Unable to contact Veteran during Out Bound Call Process — Could not appoint due to no contact from Veteran via call or work Issues (select specific issue)No Network Provider Available — No network provider available for requested service(s). This does not include a Veteran requesting a specific provider.VA Requested Providers Outside of Network — Non‐contracted provider.Veteran Requested Specific Provider — Veteran requested a specific provider for care that is not available on the PC3 network or by Community Care provider agreement.Appointed with Incorrect Provider/Type of Care — Appointed with incorrect provider or incorrect type of care.Already Appointed — Care has been previously scheduled by the Veteran, VA or the Contractor.Veteran Declined (select specific reason)Veteran Declined Distance — Inside Commute Standard — Network provider is in contractors’ network and within the commute standards.Veteran Declined Distance — Outside Commute Standard — Network provider is in contractors’ network but provider is NOT within the commute standards.Veteran Declined Appt Time — Veteran declined time for scheduled appointment.Veteran Declined Does Not Want Care — Veteran declined request for care.Veteran Declined Use of PC3/Community Care — Veteran no longer wants to participate in the program.Appointment Issues (select specific issue)Veteran No-Show — Veteran did not show up for scheduled appointment.Contractor Return – Unable to schedule within contract terms — Care not scheduled within the contractual time and VA is requesting back due to time lapse.VA Request Return – Care Already Scheduled by Contractor — VA requested the authorization after Contractor scheduled care.Unable to contact Veteran Out Bound Call Process — Could not appoint due to no contact from Veteran via call or N Return Reasons (select specific issue)No CCN Provider Available to Schedule Within Timeliness StandardNo CCN Providers Available to Schedule Within Drive Time Standard Veteran Prefers CCN Provider Outside of Drive Time Standard Veteran Willing to Accept CCN Provider Outside of Drive-Time StandardVeteran Willing to Accept CCN Provider Outside of Timeliness Standard Veteran Prefers Non-CCN Provider Veteran Self-SchedulesService Not Provided in CCNVeteran Deceased or Incapacitated — Authorization returned due Veteran deceased or incapacitated.Disposition of returned referral: - document the status of the referralScheduled using Provider Agreement.In-house VA Appointment arranged.Forwarded to in-house service.Resubmitted new referral authorization to vendor.Scheduled using Community Care.Missed Community Care Appointment, care still Active/Pending: - document the reason for the missed appointment.Veteran was No-Show for community care appointmentVeteran Canceled community care appointment (Cancel by Veteran)Community Care Provider canceled appointment (Cancel by clinic)Veteran declined/refused – using alternate source of paymentVeteran declined/refused community careRefer to clinical reviewer for disposition after unsuccessful scheduling effort — after failing to schedule an appointment by making two calls, sending a letter, and waiting two weeks, this option refers the consult to a clinician to review and disposition. Business rules for certain low-risk consults may allow the scheduler to discontinue without clinician review, or in the case the provider previously reviewed the consult and determined that it may be discontinued after a failure to schedule after mandated effort, or multiple missed appointments.Appt Tracking StepsTo view or edit the options within the Appt Tracking tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 165: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 166: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Appt Tracking tab.Figure SEQ Figure \* ARABIC 167: Appt Tracking TabSelect the best option for appointment tracking.From the Actual/Approved Provider Information section, enter the name of the actual provider with whom the Veteran has an appointment. In the Veteran informed of scheduled appt by: field, enter the method used to inform the Veteran of the schedule appointment or select an option from the Opt menu.Select the Referral Authorization Packet Mailed to Veteran if a packet was mailed to the Veteran.From the Returned from Community Care Provider: section, select the reason why the referral was returned from the Community Care Provider with the corresponding rationale.From the Disposition of returned referral drop-down menu, select the status of the referral.From the Missed Community Care Appointment care still Active/Pending drop-down menu, select the reason for the missed appointment.If the records were received, select the Records Received check box and select the option from the drop-down menu.If the Veteran is using an alternate source of payment, select the Veteran declined/refused – using alternate source of payment check box.If the Veteran does not want to use Community Care, select the Veteran declined/refused community care check box.Click OK.Secondary Authorization Request (SAR)/Request for Service (RFS)Figure SEQ Figure \* ARABIC 168: SAR/RFS TabSecondary Authorization Request (SAR)/Request for Service (RFS) sectionSAR/RFS Urgency — Insert the urgency for the secondary authorization request/request for service field or select an option from the Opt menu: Routine, w/in 48 hours, w/in 1 week, or w/in 1 month.SAR/RFS was entered into VistA ImagingYesNoSAR/RFS Details of what was Requested: - comment related to the SAR.Actions Taken Request is Clinically Appropriate – note reasons by check boxes, or with detailed description.Additional Time:Additional ServicesApproved as req. aboveDetailsRequest is not Clinically Appropriate — note reasons by check boxes, or with detailed description. Not a covered benefitMissing DocumentationReassessment by VA Provider RequiredOther reasonNot Clinically AppropriateDenial Details:SAR/RFS StepsTo view or edit the options within the SAR/RFS tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 169: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 170: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the SAR/RFS tab.Figure SEQ Figure \* ARABIC 171: SAR/RFS TabFrom the Secondary Authorization Request (SAR) / Request for Service (RFS) section, enter the SAR/RFS urgency in the field or select an option from the Opt menu.From the SAR/RFS was entered into VistA Imaging drop-down menu, select Yes or No.In the SAR/RFS Details of what was Requested field, enter the details. From the Actions Taken section, select if the SAR/RFS was clinically appropriate or not.Click OK.Consult CompletionFigure SEQ Figure \* ARABIC 172: Consult Completion TabCompletion Efforts(1st) First attempt to get records — documents first request for records for Community Care. (2nd) Second attempt to get records — documents second request for records for Community Care. (3rd) Third attempt to get records — documents third request for records for Community Care.Records Received — documents receipt of records pertinent to this consult. This is particularly useful in the case that those records cannot be uploaded to VistA Imaging immediately.Figure SEQ Figure \* ARABIC 173: Records Received Menu OptionsPaper FaxeFaxVHIESecure EmailUS MailEDI Claim AttachmentHSRMDirect – Directly from Veteran.TPA PortalOtherNo records after 3 attempts. — documents that three attempts have been made to receive records. This makes the consult a candidate for administrative closure. Community Care appointment occurred (waiting for records) – Enter information in the field or select an option from the Opt menu: Per Veteran, awaiting records/confirmation, Per TPA Portal, awaiting records, or Per Provider, awaiting records.Refer to Clinical Care Coordinator — clinical review determines next steps after care when there are no records. Consult Completion StepsTo view or edit the options within the Consult Completion tab, follow the steps below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 174: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 175: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the Consult Completion tab.Figure SEQ Figure \* ARABIC 176: Consult Completion TabFrom the Completion Efforts section, select the options for completion.In the Community Care appointment occurred (waiting for records) field, enter the information or select an option from the Opt menu.Click OK.Clinical Review OptionsProvider functions allow providers reviewing records to document the results of their review or other actions that need to be documented. Figure SEQ Figure \* ARABIC 177: Clinical Review OptionsInstructions for scheduling or rescheduling — Providers reviewing consults need to comment when they review incomplete consults (this is different from when they review a consult to accept or receive it). This can occur after a no show, or if a consult has languished, or as the result of failed scheduling efforts. An urgent consult that isn’t seen urgently must be reviewed to assure that either it wasn’t urgent medically, or the delay is the fault of the Veteran. The workflow here is that a routine appointment follows the normal scheduling protocols. If the provider indicates the appointment should be scheduled within a certain time frame, then an overbook may be required. For the scheduler, he or she should first look for an open appointment within the designated time frame, using an available appointment if one is available. Only overbook if no appointment is available. For example, if the provider says within two weeks, and there is an open appointment in 10 days, it would be inappropriate to overbook in six days when there is an open appointment available.No Show NotationSchedule/Reschedule Routine Appointment—this option is available here, but more likely would be used in the “Receive Consult” box described in more detail below.Schedule/Reschedule w/in 1 mo (overbook OK) — Schedule/Reschedule w/in 2 wks (overbook OK) — Schedule/Reschedule w/in 1 wk (overbook OK) — Schedule/Reschedule, schedule on date (overbook OK) — Schedule/Reschedule, see scheduling order for scheduling instructions — Established pt., please schedule then discontinue consult — the work flow here is important. It could be that something new has happened with the Veteran and the referring provider felt that an appointment was needed, or it could be that the referring provider didn’t realize the Veteran was already active with the clinic. If there is indeed something new going on with the Veteran, it would not be inappropriate to complete the consult as an e-consult, but in either case, the consult should result in a follow-up appointment. Typically, you’d select scheduling instructions above, and then instruct the scheduler to discontinue the consult once the follow up appointment has been scheduled. Urgent requests booked > 7 days require chart review and attestation that non-urgent scheduling is appropriate.Currently scheduled appointment appropriate—this option is for STAT consults that are scheduled more than 7 days from the create date, but after clinical review, are felt to be appropriately timed. This step is extremely important for both STAT consults and those consults stop codes identified as Level 1 (“Important and Acute”) such as cardiology, radiology, oncology, etc. The VA is wanting to make sure that Veterans with high risk conditions receive timely care. Many consults in those high-risk specialties are for low risk problems, and this is how that is documented.Additional comments and instructionsThis consult may be D/C’d after mandated scheduling effort—this option would NOT typically be used, as this is a comment, asking someone else to discontinue the consult in a separate step. It could be useful in the instance where a reviewer doesn’t have access to discontinue a consult.Scheduling plans discussed with ordering provider – this selection is simply for the convenience of the reviewing provider to document the instance where they have discussed the case with the ordering provider. This allows them to easily document that conversation took place. It doesn’t have any significant ramifications with respect to consult processing.Consults may be marked “High Risk” for tracking and extra scheduling effortHigh Risk Consult –Extra scheduling effort warranted — Consults may be flagged as high risk by the service line. Each service line should define what this means. There will be reportable separately, so they may be tracked with a higher level of scrutiny. Also, after a letter has been sent to Veteran, staff may continue to attempt to reach the Veteran by phone during the 14 days after the letter was sent. Document of additional attempts is required.Setting Clinical Review OptionsTo document the results of your review or other actions that need to be documented, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 178: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 179: Community Care Menu From the Community Care menu, select Clinical Review Options. The Clinical Review Options window opens.Figure SEQ Figure \* ARABIC 180: Clinical Review OptionsFrom the Instructions for scheduling or rescheduling section, select the instruction for consult.From the Urgent requests booked > 7 days require chart review and attestation that non-urgent scheduling is appropriate section, select the Currently scheduled appointment clinically appropriate check box for STAT consults that are scheduled more than seven days from the create date, but after clinical review, are felt to be appropriately timed. From the Additional comments and instructions section, select the appropriate option(s).From the Consults may be marked “High Risk” for tracking and extra scheduling effort section, select the High Risk Consult—Extra scheduling effort warranted check box if the consult needs extra scheduling. Click OK.Launch DSTTo launch Decision Support Tool (DST) from CTB, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 181: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 182: Community Care Menu From the Community Care menu, select Launch DST. The Decision Support Tool Dashboard opens.Figure SEQ Figure \* ARABIC 183: Decision Support Tool DashboardFor additional information regarding Decision Support Tool, please refer to the Care Coordination Decision Support Tool (DST) User Guide.Significant Findings – Community Care Action Needed NotationUse this feature to flag significant findings for the ordering provider (e.g., test results are available). This box is used with the significant findings CPRS comment to alert the ordering provider of results received especially in the case where a follow up action is needed on the part of the VA provider. Figure SEQ Figure \* ARABIC 184: Significant Findings UpdateSignificant Findings Update NotationRecords ReceivedPaper FaxeFaxVHIESecure EmailUS MailEDI Claim AttachmentHSRMDirect – Directly from Veteran.TPA PortalOtherDate of Appointment/VisitProvider NameSite/Facility NameEpisode of Care for:DiagnosisSpecialty: Services Req.Surgery/procedure complete?N/AYesNoFollow up Actions required by referring provider: (Required Field)Is there an associated Secondary Authorization Request (SAR)?YesNoReason for SARProviders: please review and complete, medical documentation in VistA Imaging.Warm Handoff was discussed with:Significant Findings StepsTo update significant findings for the ordering provider, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Significant Findings. The Update Significant Findings dialog box displays.Figure SEQ Figure \* ARABIC 185: Update Significant Findings Dialog BoxIn the Comments field, right-click to display the Significant Findings menu.Figure SEQ Figure \* ARABIC 186: Significant Findings Menu From the Significant Findings menu, select Community Care Action Required. The Significant Findings Update window displays. Figure SEQ Figure \* ARABIC 187: Significant Findings UpdateIf the records were received, select the Records Received check box and select an option from the drop-down menu.In the Episode of Care for: section, enter the diagnosis, specialty, services required, and if the surgery/procedure is complete. In the Follow up Actions required by referring provider: section, enter the required actions.Select if a Secondary Authorization Request is needed. If a Secondary Authorization Request is needed, enter the reason in the Reason for SAR field.Enter the name of the individual that the warm handoff was discussed with in the Warm Handoff discussed with: field.Click OK.Administratively CompleteAfter one attempt to obtain records, a consult may be administratively closed. This will record that the consult was closed without records, which may be tracked.Figure SEQ Figure \* ARABIC 188: Administratively CloseAdministratively Close without records after at least one attempt. — Facility Community Care staff have received confirmation that the Veteran had attended the initial visit. One attempt has been made to obtain medical records, without timely response from the community provider. This consult is being administratively closed. Two additional documented attempts must be made to obtain the medical records, if the consult is not considered low risk, per the guidance in VHA directive 1232.Administratively Close Consult StepsTo administratively close a consult, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Significant Findings. The Administratively Complete dialog box displays.Figure 189: Administratively Complete Dialog BoxIn the Comments field, right-click to display the Administratively Complete menu.Figure 190: Administratively Complete Menu From the Administratively Complete menu, select Administratively Complete. The Administratively Close dialog box displays. Figure SEQ Figure \* ARABIC 191: Administratively Close Dialog BoxSelect the Administratively Close without records after at least one attempt. check box to administratively close the consult. Selecting this check box confirms that that the Veteran received care for initial visit. One attempt has been made to obtain medical records without a timely response from the community provider. Click OK.TroubleshootingIf Consult Toolbox is not running in CPRS, the user will need to verify that Consult Toolbox in running in the system tray.If SEOC database is unavailable, a warning message will display notifying you that the SEOC Database cannot be reached for the most current SEOCs. SEOCs previously downloaded will still be available on the Authorization tab. Contact the NSD if no SEOCs are available.National Service Desk and Organizational ContactsFor issues related to the Consult Toolbox that cannot be resolved by this manual or the site administrator, please contact the National Service Desk at 855-NSD-HELP (673-4357).Acronyms and AbbreviationsAcronymDefinitionCACClinical Application CoordinatorsCANCare Assessment NeedCCADCommunity Care Agile DevelopmentCDWCorporate Data WarehouseCIDClinically Indicated DateCOSChief of StaffCPRSComputerized Patient Record SystemCTBConsult ToolboxDOADelegation of AuthorityDoDDepartment of DefenseDST Decision Support ToolHECHealth Eligibility CenterNSDNational Service DeskOI&TOffice of Information and TechnologyOptOptionPCPPrimary Care PhysicianRFSRequest for ServiceSARSecondary Authorization RequestSEOCStandardized Episode of CareSOPStandard Operating ProcedureURLUniversal Record LocationVADepartment of Veterans AffairsVAMCVA Medical CenterVDLVA Software Document LibraryVHAVeterans Health AdministrationVistAVeterans Health Information Systems and Technology ArchitectureVVCVA Video ConnectAppendix A: Management of Consults when COVID-19 Workflow is EnabledIn March 2020, a national crisis was declared with nearly nationwide requests for all non-essential services to be suspended and people shelter in their homes to avoid the spread of the COVID-19 virus. Impact on the VA included cancellation of most elective procedures and outpatient clinics. This included cancellation of many appointments associated with consults.The Office of Veterans Access to Care (OVAC) and the Office of Community Care (OCC), have partnered to develop the COVID-19 workflows within the CTB version 1.9.0063 to aid in prioritizing scheduling and rescheduling Veterans in VA and the community during the COVID-19 Pandemic. The functionality described below replaces the standard Receive Consult and Clinical Review workflows when the COVID-19 workflow is enabled. Appendix A1: Receiving Consult Activities when COVID-19 Workflow is EnabledClinicians and/or delegated administrative staff receive View Alert in CPRS/ of VA order/consult notification. When a provider receives a pending consult, review should include determination of whether the consult is appropriate to be scheduled, and optionally, additional direction can be given to the scheduler.The Receiving Consult Activities is used by any clinic in the VA facility that receives a consult. This clinic may be an internal VA clinic or a community care clinic.When the COVID-19 workflow is enabled, the Receiving and Rescheduling Consult Options window is accessible from the Receive option and the COVID-19 Priority tab is accessible from the Community Care functions. These windows provide the ability to prioritize consults due to the COVID-19 Pandemic.Appendix A1.1: VA Clinic ReferralsThis section replaces section 4.1 REF _Ref42717909 \h \* MERGEFORMAT Receiving Consult Activities when the Enable COVID-19 workflow for Receive Consult and Clinical Review options check box is selected under the REF _Ref42718517 \h \* MERGEFORMAT Other User Settings Tab. Figure SEQ Figure \* ARABIC 192: Receiving and Rescheduling Consult Options WindowAccept new consult, received during COVID-19 Pandemic –this selection applies if the reviewing provider has determined that the Veteran’s medical condition warrants them being seen during the COVID-19 Pandemic.Established pt., please schedule when appropriate then discontinue consult - this selection applies if a consult is received for an established patient. Once the consult is received, it is sent to the scheduler to make the appointment. Once the appointment is made, the consult can be discontinued.Scheduling / Rescheduling Instructions (Selecting a Priority Automatically Accepts Consult) – when receiving or reviewing a consult, a scheduling priority can be indicated.COVID-19 Priority 1 – Care should be appointed despite COVID-19 - do not wait until normal operations, schedule appointment now.COVID-19 Priority 2 – For appointing per clinical appropriateness and scheduling capacity - first group to schedule when normal operations begin. Community Care consults should also be scheduled based on local market availability.COVID-19 Priority 3 - Make appointment as Priority 3 status, per local guidance - optional, but a way to separate less urgent consults from the Priority 2. Your department can define criteria how to separate 2 from 3.COVID-19 Priority 4 - Make appointment as Priority 4 status, per local guidance - optional, a way to separate non-urgent consults from the Priority 3. Again, you can define which ones belong to this category or if you use it at all.As an alternative to a face-to-face appointment, the Veteran may be offered: Telehealth - Telehealth Appointment may be offered to the Veteran.Telephone - Telephone Appointment may be offered to the Veteran.Video Appt (VVC)- VA Video Connect (VVC) appointment may be offered to the Veteran.Check All – Selects all three options.Additional Scheduling Instruction and CommentsFor Priority 1 – you may indicate a specific date for overbook:Schedule on MM/DD/YYYY, ok to overbook - Accept consult see scheduling order for scheduling instructions—this selection applies if the clinic or service provider prefers to convey scheduling instructions via a CPRS order.Additional FlagsThis consult may be D/C’d after mandated scheduling effort—this option allows the reviewing provider to determine at the time of acceptance that if the staff is unable to get the appointment scheduled, or if the Veteran cancels or no-shows twice, then the consult can be discontinued by the scheduler without having another clinical review. The consult is returned to the ordering provider to take whatever action deemed appropriate.The This consult may be discontinued d/c’d after 1 missed appointment (approved low risk clinic) check box described below is only visable when enabled in the Consult Toolbox Settings.This consult may be D/C’d after 1 missed appointment (approved low risk clinic)- – An additional option for low risk clinics exists for discontinuation after one missed appointment. This screen auto populates from settings described above.Scheduling plans discussed with ordering providerConsults May Be Marked “High Risk” for Tracking and Extra Scheduling EffortHigh Risk Consult—Extra scheduling effort warranted – this will flag this consult as having a medically high-risk condition that warrants additional calls to the Veteran beyond the mandated minimum necessary effort. It also allows the receiving service to flag certain consults for closer follow up when the Veteran fails to keep appointments. Each service may define what high risk means to them. This is simply a way of segregating higher risk consults from the rest and notifying the staff to expend additional effort.Extra scheduling effort – allows the reviewer to specify what additional effort they would like. In addition to the selection of options, the user may type in other instructions.Figure SEQ Figure \* ARABIC 193: Extra Scheduling Effort OptionsTo receive or schedule a consult during the COVID-19 Pandemic, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 194: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 195: Receive MenuFrom the Receive menu, select Receive Consult. The Receiving and Rescheduling Consult Options window opens.Figure 196: Receiving and Rescheduling Consult Options WindowSelect the Accept new consult, received during COVID-19 Pandemic check box to accept consults. If the Veteran is an established patient, then select the Established pt., please schedule when appropriate then discontinue consult check box. From the Scheduling / Rescheduling Instructions section, select the appropriate COVID-19 priority. From the As an alternative to a face-to-face appointment, the Veteran may be offered: section, select if the Veteran may attend the appointment via Telehealth, Telephone, Video Appt, or select Check All for all three options.In the Additional Scheduling Instruction and Comments text box, enter additional information if needed.From the For Priority 1 – you may indicate a specific date for overbook: section, select the Schedule check box and enter/select a specific date.From the Additional Flags section, select the check box if the consult may be discontinued after mandated scheduling effort. If the consult can be discontinued, select the check box if the consult may be discontinued after one missed appointment.Low risk clinics must have approval from the facility to use the one missed appointment option.If the scheduling plans has been discussed with the ordering provider, select the Scheduling plans discussed with ordering provider check box. If the consult is high risk and needs to be tracked and extra scheduling efforts, select the High Risk Consult—Extra scheduling effort warranted check box from the Consults May Be Marked “High Risk” for Tracking and Extra Scheduling Effort section.If the consult is high risk, from the Extra scheduling effort drop-down menu select the option to specify what additional effort you would like.Click OK.Appendix A1.3: Receive Community Care Functions: COVID-19 PriorityThis section replaces section 4.1 REF _Ref42717909 \h \* MERGEFORMAT Receiving Consult Activities when the Enable COVID-19 workflow for Receive Consult and Clinical Review options check box is selected under the REF _Ref42718517 \h \* MERGEFORMAT Other User Settings Tab. Figure 197: Receive Community Care Functions: COVID-19 Priority TabThe clinical triage for Community Care scheduling priority must be completed and documented by a clinicianAccept new consult, received during COVID-19 Pandemic - this selection applies if the reviewing provider has determined that the Veteran’s medical condition warrants them being seen during the COVID-19 Pandemic.Scheduling / Rescheduling Instructions (Selecting a Priority Automatically Accepts Consult)COVID-19 Priority 1 – Care should be appointed despite COVID-19 - do not wait until normal operations, schedule appointment now.COVID-19 Priority 2 – For appointing per clinical appropriateness and scheduling capacity - first group to schedule when normal operations begin. Community Care consults should also be scheduled based on local market availability.COVID-19 Priority 3 - Make appointment as Priority 3 status, per local guidance - optional, but a way to separate less urgent consults from the Priority 2. Your department can define criteria how to separate 2 from 3.COVID-19 Priority 4 - Make appointment as Priority 4 status, per local guidance - optional, a way to separate non-urgent consults from the Priority 3. Again, you can define which ones belong to this category or if you use it at all.As an alternative to a face-to-face appointment, the Veteran may be offered:Telehealth - Telehealth Appointment may be offered to the Veteran.Telephone - Telephone Appointment may be offered to the Veteran.Check All – Selects both options.Additional Scheduling Instruction and CommentsTo set the Community Care COVID-19 Priority options, follow the steps listed below:The clinical triage for Community Care scheduling priority must be completed and documented by a clinician/Delegation of Authority (DOA).From the Action menu, select Consult Tracking…, and then select Receive. The Receive Consult dialog box opens.Figure SEQ Figure \* ARABIC 198: Receive Consult Dialog BoxIn the Comments field, right-click to display the Receive menu.Figure SEQ Figure \* ARABIC 199: Receive MenuFrom the Receive menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the COVID-19 Priority tab.Figure 200: COVID-19 Priority TabSelect the Accept new consult, received during COVID-19 Pandemic check box to accept consults. From the Scheduling / Rescheduling Instructions section, select the appropriate COVID-19 priority. From the As an alternative to a face-to-face appointment, the Veteran may be offered: section, select if the Veteran may attend the appointment via Telehealth, Telephone, or Check All for both options.In the Additional Scheduling Instruction and Comments text box, enter additional information if needed.Click OK.Appendix A2: Setting Clinical Review Options when COVID-19 Workflow is EnabledProvider functions allow providers reviewing records to document the results of their review or other actions that need to be documented.When the COVID-19 workflow is enabled, the Receiving and Rescheduling Consult Options window is accessible from the Clinical Review Options and the COVID-19 Priority tab is accessible from the Community Care functions. These windows provide the ability to prioritize consults due to the COVID-19 Pandemic.Appendix A2.1: VA Clinical ReferralsThis section replaces section 4.1 REF _Ref42717909 \h \* MERGEFORMAT Receiving Consult Activities when the Enable COVID-19 workflow for Receive Consult and Clinical Review options check box is selected under the REF _Ref42718517 \h \* MERGEFORMAT Other User Settings Tab. Figure SEQ Figure \* ARABIC 201: Receiving and Rescheduling Consult Options Window: VA Clinic Referrals TabEstablished pt., please schedule when appropriate then discontinue consult - this selection applies if a consult is received for an established patient. Once the consult is received, it is sent to the scheduler to make the appointment. Once the appointment is made, the consult can be discontinued.Scheduling / Rescheduling Instructions (Selecting a Priority Automatically Accepts Consult) – when receiving or reviewing a consult, a scheduling priority can be indicated.COVID-19 Priority 1 – Care should be appointed despite COVID-19 - do not wait until normal operations, schedule appointment now.COVID-19 Priority 2 – For appointing per clinical appropriateness and scheduling capacity - first group to schedule when normal operations begin. Community Care consults should also be scheduled based on local market availability.COVID-19 Priority 3 - Make appointment as Priority 3 status, per local guidance - optional, but a way to separate less urgent consults from the Priority 2. Your department can define criteria how to separate 2 from 3.COVID-19 Priority 4 - Make appointment as Priority 4 status, per local guidance - optional, a way to separate non-urgent consults from the Priority 3. Again, you can define which ones belong to this category or if you use it at all.As an alternative to a face-to-face appointment, the Veteran may be offered: Telehealth - Telehealth Appointment may be offered to the Veteran.Telephone - Telephone Appointment may be offered to the Veteran.Video Appt (VVC)- VA Video Connect appointment may be offered to the Veteran.Check All – Selects all three options.Additional Scheduling Instruction and CommentsFor Priority 1 – you may indicate a specific date for overbook:Schedule on MM/DD/YYYY, ok to overbook - Accept consult see scheduling order for scheduling instructions—this selection applies if the clinic or service provider prefers to convey scheduling instructions via a CPRS order.Additional FlagsThis consult may be D/C’d after mandated scheduling effort—this option allows the reviewing provider to determine at the time of acceptance that if the staff is unable to get the appointment scheduled, or if the Veteran cancels or no-shows twice, then the consult can be discontinued by the scheduler without having another clinical review. The consult is returned to the ordering provider to take whatever action deemed appropriate.Scheduling plans discussed with ordering providerConsults May Be Marked “High Risk” for Tracking and Extra Scheduling EffortHigh Risk Consult—Extra scheduling effort warranted – this will flag this consult as having a medically high-risk condition that warrants additional calls to the Veteran beyond the mandated minimum necessary effort. It also allows the receiving service to flag certain consults for closer follow up when the Veteran fails to keep appointments. Each service may define what high risk means to them. This is simply a way of segregating higher risk consults from the rest and notifying the staff to expend additional effort.Extra scheduling effort – allows the reviewer to specify what additional effort they would like. In addition to the selection of options, the user may type in other instructions.Figure SEQ Figure \* ARABIC 202: Extra Scheduling Effort OptionsTo add a comment to a consult to provide scheduling guidance during the COVID-19 Pandemic, follow the steps listed below:From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 203: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 204: Community Care Menu From the Community Care menu, select Clinical Review Options. The Receiving and Rescheduling Consult Options window opens.Select the VA Clinic Referrals tab.Figure SEQ Figure \* ARABIC 205: VA Clinic Referrals TabIf the Veteran is an established patient, then select the Established pt., please schedule when appropriate then discontinue consult check box.From the Scheduling / Rescheduling Instructions section, select the appropriate COVID-19 priority. From the As an alternative to a face-to-face appointment, the Veteran may be offered: section, select if the Veteran may attend the appointment via Telehealth, Telephone, Video Appt (VVC), or Check All for all three options.In the Additional Scheduling Instruction and Comments text box, enter additional information if needed.From the For Priority 1 – you may indicate a specific date for overbook: section, select the Schedule check box and enter/select a specific date.From the Additional Flags section, select the check box if the consult may be discontinued after mandated scheduling effort. If the consult can be discontinued, select the checkbox if the consult may be discontinued after one missed appointment.Low risk clinics must have approval from the facility to use the one missed appointment option.If the scheduling plans has been discussed with the ordering provider, select the Scheduling plans discussed with ordering provider check box. If the consult is high risk and needs to be tracked and extra scheduling efforts, select the High Risk Consult—Extra scheduling effort warranted check box from the Consults May Be Marked “High Risk” for Tracking and Extra Scheduling Effort section.If the consult is high risk, from the Extra scheduling effort drop-down menu select the option to specify what additional effort you would like.Click OK.Appendix A2.2: Community Care ReferralsThis section replaces section 4.1 REF _Ref42717909 \h \* MERGEFORMAT Receiving Consult Activities when the Enable COVID-19 workflow for Receive Consult and Clinical Review options check box is selected under the REF _Ref42718517 \h \* MERGEFORMAT Other User Settings Tab. Figure SEQ Figure \* ARABIC 206: Receiving and Rescheduling Consult Options: Community Care Referrals TabThe clinical triage for Community Care scheduling priority must be completed and documented by a clinician/DOAScheduling / Rescheduling Instructions (Selecting a Priority Automatically Accepts Consult)COVID-19 Priority 1 – Care should be appointed despite COVID-19 - do not wait until normal operations, schedule appointment now.COVID-19 Priority 2 – For appointing per clinical appropriateness and scheduling capacity - first group to schedule when normal operations begin. Community Care consults should also be scheduled based on local market availability.COVID-19 Priority 3 - Make appointment as Priority 3 status, per local guidance - optional, but a way to separate less urgent consults from the Priority 2. Your department can define criteria how to separate 2 from 3.COVID-19 Priority 4 - Make appointment as Priority 4 status, per local guidance - optional, a way to separate non-urgent consults from the Priority 3. Again, you can define which ones belong to this category or if you use it at all.As an alternative to a face-to-face appointment, the Veteran may be offered:Telehealth - Telehealth Appointment may be offered to the Veteran.Telephone - Telephone Appointment may be offered to the Veteran.Check All – Selects both options.Additional Scheduling Instruction and CommentsTo add a comment to a consult to provide scheduling guidance during the COVID-19 Pandemic, follow the steps listed below:The clinical triage for Community Care scheduling priority must be completed and documented by a clinician/DOA.From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 207: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 208: Community Care Menu From the Community Care menu, select Clinical Review Options. The Receiving and Rescheduling Consult Options window opens.Select the Community Care Referrals tab.Figure 209: Community Care Referrals TabFrom the Scheduling / Rescheduling Instructions section, select the appropriate COVID-19 priority. From the As an alternative to a face-to-face appointment, the Veteran may be offered: section, select if the Veteran may attend the appointment via Telehealth, Telephone, or Check All for both options.In the Additional Scheduling Instruction and Comments text box, enter additional information if needed.Click OK.Appendix A2.3: Add Comment Community Care Functions: COVID-19 PriorityThis section replaces section 4.1 REF _Ref42717909 \h \* MERGEFORMAT Receiving Consult Activities when the Enable COVID-19 workflow for Receive Consult and Clinical Review options check box is selected under the REF _Ref42718517 \h \* MERGEFORMAT Other User Settings Tab. Figure 210: Add Comment Community Care Functions: COVID-19 Priority TabThe clinical triage for Community Care scheduling priority must be completed and documented by a clinician/DOAScheduling / Rescheduling Instructions (Selecting a Priority Automatically Accepts Consult)COVID-19 Priority 1 – Care should be appointed despite COVID-19 - do not wait until normal operations, schedule appointment now.COVID-19 Priority 2 – For appointing per clinical appropriateness and scheduling capacity - first group to schedule when normal operations begin. Community Care consults should also be scheduled based on local market availability.COVID-19 Priority 3 - Make appointment as Priority 3 status, per local guidance - optional, but a way to separate less urgent consults from the Priority 2. Your department can define criteria how to separate 2 from 3.COVID-19 Priority 4 - Make appointment as Priority 4 status, per local guidance - optional, a way to separate non-urgent consults from the Priority 3. Again, you can define which ones belong to this category or if you use it at all.As an alternative to a face-to-face appointment, the Veteran may be offered:Telehealth - Telehealth Appointment may be offered to the Veteran.Telephone - Telephone Appointment may be offered to the Veteran.Check All – Selects both options.Additional Scheduling Instruction and CommentsTo set the Community Care COVID-19 Priority options during the COVID-19 Pandemic, follow the steps listed below:The clinical triage for Community Care scheduling priority must be completed and documented by a clinician/Delegation of Authority (DOA).From the Action menu, select Consult Tracking…, and then select Add Comment. The Add Comment to Consult dialog box displays.Figure SEQ Figure \* ARABIC 211: Add Comment to Consult Dialog BoxIn the Comments field, right-click to display the Community Care menu.Figure SEQ Figure \* ARABIC 212: Community Care Menu From the Community Care menu, select Community Care Functions. The Community Care Functions window opens with the MSA Elig. Verification tab displayed.Select the COVID-19 Priority tab.Figure 213: COVID-19 Priority TabFrom the Scheduling / Rescheduling Instructions section, select the appropriate COVID-19 priority. From the As an alternative to a face-to-face appointment, the Veteran may be offered: section, select if the Veteran may attend the appointment via Telehealth, Telephone, or Check All for both options.In the Additional Scheduling Instruction and Comments text box, enter additional information if needed.Click OK.Appendix B: Consult Factor Types and DefinitionsConsult Factor TypeConsult Factor TextA1-Accept consult, schedule within 1 week, (OK to overbook).A1MAccept consult, schedule within 1 month (OK to overbook).A2-Accept consult, schedule within 2 weeks, (OK to overbook).AARApproved as Requested (SAR)AB-Address bad or no address on file, unable to send letter.AC-Accept consult, schedule routine appointment.ACCAdmin Screening Care CoordinationACFCommunity care approved under Choice First.ACNAdministratively closed without recordsADTAccept Consult, schedule on specific date, ok to overbookAEVAdministrative Eligibility verified.AFDAFD-DST Forward To: servicenameAFUAFU-Total Authorized Units/Visits:ALRAlert Sent to: nameofpersonANVCommunity care approved under NVCC.AOKMailing Address ConfirmedAPPDoD Consult ApprovedAS-Accept consult, see scheduling order for scheduling instructions.C1-First call to veteran, unable to schedule.C1CComm Care First Call to VeteranC2-Second call to veteran, unable to schedule.C2CComm Care Second Call to VeteranC3-Third or subsequent call to Veteran(unsuccessful scheduling)C3-Third or additional call to veteran, unable to schedule.C3CComm Care Third or subseq. Call to VeteranCA-Clinically Appropriate to wait for the scheduled appointment.CADVista cancellation for Administrative reasonCANAdministratively closed without recordsCAPCommunity care approved for specified program.CAPCommunity care approved for specified program.CATCAT-SEOC CoC:CB-Patient contacted but pt will call back to schedule later.CBDCBD-Care authorization expires onCCAA community care appt has been CCommunity Care Cancelled by PatientCCDCommunity Care Appointment Date: CCECC Eligibility Status:CCHCommunity Care Appt Scheduling to be handled by:CCLVista Cancelled by ClinicCCMCare Coordination was manually SetCCOCare Coordination Time Spent:CCPCommunity Care Cancelled by ClinicCCRCommunity Care Provider: CCRCommunity Care Provider: CCSCommunity Care Appointment has been ScheduledCEVChoice Eligibility Verified.CEVChoice Eligibility Verified.CHDContractor Not Used: Community Provider declines Choice Network participation.CHDCHD-Community Provider declines Choice Network participationCHNNetwork Provider not accepting Choice patientsCHNContractor Not Used: Network Provider not accepting Choice, patients.CHUContractor Not Used: Choice Provider unable to schedule within CID (Urgency)CHUChoice Provider unable to schedule within CID (Urgency)CHVVeteran declined appointment due to date/time/distanceCHVContractor Not Used: Veteran declined appointment due to date/time/distance.CIDPrior CID=FactorData after Edit/ResubmitCLAAdmin Screening Care Coordination:CLCClinical Triage Care Coordination:CLVCare Coordination LevelCMPCompleted ConsultCNCConsult CancelledCNSCommunity Care Veteran No Show for ApptCOCCommunity care appointment occurred, per patient (awaiting confirmation).COIVeteran OPT-IN for choice.COOVeteran OPT-OUT for choice.CORCommunity care appointment occurred, records received.COTCommunity care appointment occurred, per TPA portal, awaiting records.CP1Cancelled by patient, first missed appointment.CP2Cancelled by patient, second missed appointment.CPPConsult ready for CPP ReferralCPTVista Cancelled by PatientCSCCSC-Consult stop codeCSNCSN-Clinical Service:CSTCST-Consult service type:CTCClinical Triage: CompleteCTNClinical Triage: Not RequiredCTRClinical Triage: RequiredCU-Patient states that they have an appointment scheduled through the Veterans Choice program, however there is no documentation to this effect in the consult.CVAAccept new consult, received during COVID-19 PandemicCV1COVID-19 Priority 1. Schedule appointment despite COVID-19 restrictions.CV2COVID-19 Priority 2. For appointing per clinical appropriateness and scheduling capacity.CV3COVID-19 Priority 3. Make appointment as Priority 3 status, per local guidanceCV4COVID-19 Priority 4. Make appointment as Priority 4 status, per local guidanceDAFDAF-DST Forwarding: Yes/NoDCADCA-DST CC Best Interest of Vet:DCBDST CC Best Interest of Vet:DCCDST CC eligibility: No clinic appts availableDCDDST CC eligibility: DRIVE TIMEDCFDST CC Best Interest of Vet:DCGDCG-DST CC eligibility: GRANDFATHEREDDCHDST CC eligibility: HARDSHIPDCIDST CC Best Interest of Vet:DCODCO-DST CC Best Interest of Vet:DCPDoD Consult PresentDCQDST CC Best Interest of Vet:DCSIf no apt within 30 days Discuss with clinical staffDCTDST CC Best Interest of Vet:DCVDST CC eligibility: NO FULL-SVC VHA FACILITYDCXDST Service not offered within search radiusDCYDST IFC agreement not availableDDODoD Date of Svc Outside of Approved EOCDECPatient declines/refuses-does not want appointment. Please submit new consult if patient agrees to care.DISDisapprove ReasonDLADelegation of Auth.: AdministrativeDLCDelegation of Auth.: ClinicalDNCNon DoD consult presentDNFDST No VHA facilities within search radius DNPDoD Consult Not PresentDNYRequest for community care is disapproved.DOKOK to leave appt. details withDPScheduling plans discussed with ordering provider.DSCDiscontinued ConsultDSFDocuments sent via fax to community care provider.DSODisassociate ReportDSPDSP-DST data saved prior to signing consultDSTDST-DST ID:DTEDTE-Veteran's Day/Date Preference:DU-Document Uploaded to TPA Portal.DUPDuplicate Request.DVEDVE-DST Vista ErrorE90No appointment within 90 daysEDCEstablished patient, follow-up appointment has been scheduled.EEFExtra Scheduling Effort requestedENVEnvironmental factors:ERSEdit/ResubmitESTEstablished patient, please schedule appt. then DC consult.EWLOn EWL or awaiting CHOICE. Pt added to Electronic Wait List, no available appt w/in 90 days.EXPPatient has expired.FDXFDX-Veteran has an active Third Party Release on file.FSEFailed mandated scheduling effort (multiple missed/cancelled appts. or patient did not respond to mandated scheduling effort). Consult discontinued, per VA consult management policy. Please submit a new request if care is still desired and patient agrees to receiving care.FUVFollow up call made to provider/vendor to check on status.FWDFORWARDED FROMFWRFWD TO REMOTE SERVICEG30Appointment is greater than 30 days from PIDGEOGeographical challenges:GVMGuideline Method used for approvalHECPresumed eligible, HEC Update Pending.HR-High risk consult, please continue to attempt scheduling even after mandatory scheduling effort.HSRConsult ready for HSRM ReferralICRICR-Initiate Community Care ReferralINCINCOMPLETE RPTINFVeteran informed of eligibility, referral and approval.L1-L1-Unable to schedule letter sent by mail to Veteran.L1-Letter sent to patient.L1CCommunity Care unable to contact letter sent by Mail.LC-Certified letter sent to patient regarding scheduling.LCCCommunity Care unable to contact letter sent by Certified Mail.LDTShortest average drive time (min):LM-Left message on voice mail.LMFLeft message with family member.MA3Third or more missed appointments.MATApproval for maternity careMEMay discontinue if Veteran cancels/no-shows once or fails to respond to mandated scheduling effort.MEDMedical condition:MFUFollow up call made to veteran while on wait list to confirm wait list status.MIEExplanation of BMI - OTHER:MLSWilling to travel up to (miles):MOKMOK-OK to leave appt. details on voice mail.MSCScheduled but not from VistANAANext avail clinic appt:NAENot administratively eligible.NAPDoD Consult Not ApprovedNELPatient does not meet eligibility No earlier than date:NLTNo later than date:NN-Care is no longer needed.NNANEW NOTE ADDEDNOSVA facility does not provide the required serviceNR-No records received after three attempts.NS1No Show, first missed appointment.NS2No Show, second missed appointment.NSHVista Patient was a No-ShowNVAThe care will be provided through a Community Care Consult.NVDNon-VA Care disapproved.NVDCommunity Care disapproved.NVNCommunity Care not needed, care provided by VA appointment.NVNNon-VA care not needed, care provided by VA appointment.NXCNot eligible for Choice.OCCOk to send to Community Care if no apt within 30 daysODCOther discontinuation reason: OTHVista cancellation for other reasonOTPOTP-Veteran OK to see other than Preferred ProviderP30Procedure scheduled greater than 30 days from PIDPACProvider was contacted for Alternate Plan of CarePB-Phone contact number bad/incorrect or disconnected.PFPPFP-Veteran's Preferred ProviderPKTReferral Packet mailed to veteran.PRACommunity Care Provider has accepted referralPRCProcedure(s) Approved for Community CarePRDProcedure RequestedPRFPreferred notification method:PRQProvider requires records to review prior to scheduling.PSPPatient's actual Scheduled ProviderPVTPatient declines/refuses-going to private provider outside VA care. R1-First attempt to get records from community care.R1-First attempt to get records from community care.R2-Second attempt to get records from community care.R3-3rd attempt to get records from community care.R3-Third attempt to get records from community care.R3-3rd attempt to get records from community careRACRefer to clinical reviewer for administrative completion.RCFRCF-Received 7332 signed ROI Form, ready to schedule.RECReceive ConsultREFVeteran declined/refused-does not want appointment.REFVeteran refuses Community Care appointment.REFPatient refuses non-VA appointment.RELREL-Veteran has a signed ROI for 7332 conditions on file.RFCPatient declined/refused community care.RFVReferral returned from community care vendor.ROIMailed 7332 ROI Form to enable this referral to proceed.RP-Referred to provider for disposition after unsuccessful scheduling effort.RP-Referred to provider for disposition after unsuccessful scheduling effort.RP-Referred to provider for disposition after unsuccessful scheduling effort.RR-Records from community care provider received.RRH Records Received via:S1MSchedule/reschedule within 1 month, ok to overbook.S1WSchedule/reschedule within 1 week, ok to overbook.S2WSchedule/reschedule within 2 weeks, ok to overbook.SARSecondary Authorization RequestSCCThis Referral is for a Service Connected Condition.SCDAdministrative Care Coordination ScreeningSCRService/Care Approved for Community CareSDCPatient still desires care.SDTAccept Consult, schedule on specific date, ok to overbookSDXSDX-Veteran has dx requiring 7332 ROI.SEOStandard Episode of CareSEVSpecific Eligibility:SIGSIG FINDING UPDATESIMNature or simplicity of service (UEXB):SORSchedule/reschedule-see Scheduling Order for instructions.SPAThis referral is for Special Authority.SPCSpecialty Approved for Community CareSR-Schedule/reschedule routine appointment.SRASAR Approval StatusSSCSSC-Veteran prefers to self schedule appointment.SSCVeteran prefers to self-schedule appointment.SSPSubspecialty Approved for Community CareSURSAR Urgency:SV-Spoke with veteran/care giver.SVCServices requested.TCCClinical Triage Care CoordinationTCDClinical Care Coordination TriageTELTelephone Appointment may be offered to the VeteranTFRTimeframe for Episode of Care ApprovedTHLTelehealth Appointment may be offered to the VeteranTIMTIM-Veteran's Time Preference: AnyTOSType of serviceUCHPrior Urgency after Edit/ResubmitUNVUnable to Verify EligibilityURGUrgency:US1Unable to Schedule: Wants VA care (opts out CC) and is waiting for availability. Care need is not met.US2Unable to Schedule: Service is unique to VAUS3Unable to Schedule: Care needs being met in VA while waiting for unique specialized VA serviceUXBUnusual or Excessive travel burdenVCAVista cancellation for other reasonVCCVeteran CC Option:VCLOn EWL or awaiting CHOICE. Pt added to VCL.VCLVeteran placed on VCLVDSReturned Referral DispositionVPPVPP-Receipt Package Preference:VSCVista Scheduled AppointmentVST%Sar Request Sent to VISTA Imaging%VTCVTC-Veteran contacted Community Care.VVCVVC Appointment may be offered to the VeteranWHOThis consult was discussed with and handed off toXXCSome other status change reason ................
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